婴幼儿腹泻的轮状病毒检测分析及其流行病学特征

Epidemiological characteristics of infant diarrhea caused by cluster A rotavirus

目的 探讨A群轮状病毒所致婴幼儿腹泻的流行病学特征。方法 回顾性调查分析北京友谊医院2012年1月至2014年12月1 484例婴幼儿腹泻患儿,行胶体金法直接检测A群轮状病毒抗原,对患儿的性别、年龄、月份及大便常规特点等进行归纳总结分析。结果 1 484例婴幼儿大便中检出A群轮状病毒抗原阳性278例,阳性率18.73%。男、女婴幼儿阳性率分别为18.47%和19.08%,不同性别间无显著差异（P〉0.05）;6个月至1岁,1~2岁和2~3岁年龄组为易感染A群轮状病毒婴幼儿年龄组,其阳性率分别为18.97%,23.97%和20.26%;5月和8月感染率最低,其阳性率分别为0.93%和0,而11月和12月为高发月份,阳性率分别为46.74%和39.26%;阳性大便标本中糊状便占比最高（40%）,粪便常规中潜血试验、白细胞、红细胞与轮状病毒抗原检测Kappa一致率和相关性较低,脂肪球则Kappa一致率较高。结论 A群轮状病毒所致的婴幼儿腹泻中,12月龄到2岁婴幼儿为高发年龄,11月和12月为高发月份,粪便出现糊状便、脂肪球成分应高度考虑轮状病毒感染。

Objective To discuss the clinical and epidemiological characteristics of infants acute diarrhea caused by cluster A rotavirus （RV）. Methods 1484 cases of stool samples from infants with diarrhea in a hospital were detected by technique of colloidal gold assay. Epide- miological data of infants were analyzed. Results Among 1484 detected stool samples, 278 （ 18.73 % ） cases were positive RV antigen, RV infec- tion rate in male and female was 18.47% and 19.08% respectively （ P 〉0.05 ）. The most susceptible age of the infection was 0.5 to 1 years old, 1 ~ 2 years old and 2 ~ 3 years old, the positive rate was 18.97 % , 23.97 % and 20.26% respectively, there were significant differences in the positive rates of RV antigen between infants at age of less than 6 months and greater than 3 years old groups （ P 〈 0.01 ）. The positive rate of RV antigen from May and August was 0.93% and 0 respectively, while November and December was 46.74% and 39.26% respectively. Con- dusion The most susceptible age of infection was 12 months to 2 years old in infants with diarrhea caused by cluster A rotavirus. The incidence peak of RV infection was in November and December. We should highly consider rotavirus infection when mushy stool and fat ball were found in the feces of infants.