2019-2022年北京市某医院急性胃肠炎儿童粪便轮状病毒与腺病毒的抗原检测及临床分析

Fecal rotavirus and adenovirus antigen detection and clinical analysis of children with acute gastroenteritis in a hospital of Beijing City from 2019 to 2022

本文为一项单中心回顾性研究,分析2019年2月至2022年1月期间就诊于北京清华长庚医院儿科门诊的5岁以下急性胃肠炎患儿,通过胶体金免疫层析法检测粪便中轮状病毒(rotavirus,RV)和人腺病毒(human adenovirus,HAdV)抗原。剔除不符合病例及重复病例后纳入2896例,其中559例至少检出1种病毒抗原,将患儿按检测结果分为RV阳性组、HAdV阳性组、RV与HAdV双阳性组,采用χ^(2)检验、方差分析及非参数检验比较性别、年龄、季节分布、临床表现及相关实验室检查。结果显示,在2896例患儿送检的非重复样本中,RV抗原阳性率为6.21%(180/2896),HAdV抗原阳性率为10.91%(316/2896),RV与HAdV双阳性率为2.18%(63/2896)。2021年HAdV抗原阳性率为16.11%(178/1105),较2020年的6.20%(53/855)有显著升高。RV感染有明显的季节性,春、冬季是高发季节(χ^(2)=74.018,P<0.001),而HAdV感染无明显季节性(χ^(2)=2.110,P=0.550),呈全年散发感染。RV感染患儿的发热、呕吐症状比例均显著高于HAdV感染组(χ^(2)=40.401,P<0.001;χ^(2)=32.593,P<0.001),但粪便中白细胞阳性率显著低于HAdV感染组(13.741,P<0.01)。综上,关注RV和HAdV的流行病学变化对急性胃肠炎儿童的临床诊疗及疾病防控有重要意义。

As a single-center retrospective study,we analyzed the results of rotavirus and human adenovirus antigens in stool samples with colloidal gold immunochromatography method in children with acute gastroenteritis under the age of five who were treated in our hospital from 2019 to 2022.After excluding nonconforming cases and duplicate cases,2896 cases were included,of which 559 cases were detected with at least one viral antigen.According to the test results,they were divided into RV positive group,HAdV positive group and RV&HAdV double positive group.The gender,age,seasonal distribution,clinical symptoms and related laboratory tests were compared and analyzed withχ^(2) test,analysis of variance and nonparametric test.Among the single samples from 2896 children,the positive rate of RV antigen was 6.21%(180/2896),the positive rate of HAdV antigen was 10.91%(316/2896),and the double positive rate of RV&HAdV was 2.18%(63/2896).The positive rate of HAdV antigen in 2021 was 16.11%,a significant increase compared with 6.20%in 2020.RV infection has obvious seasonality,and spring and winter are the seasons with high incidence of infection(χ^(2)=74.018,P<0.001),while HAdV infection has no obvious seasonality(χ^(2)=2.110,P=0.550),showing sporadic infection throughout the year.The proportions of fever and vomiting symptoms in children with RV infection were significantly higher than those in the HAdV infection group(χ^(2)=40.401,P<0.001;χ^(2)=32.593,P<0.001),but the positive rate of white blood cells in the stool was significantly lower than that in the HAdV infection group(χ^(2)=13.741,P<0.01).In summary,paying attention to the epidemiological changes of RV and HAdV is of great significance for clinical diagnosis and treatment and disease prevention and control.