苏浙闽地区婴幼儿急性腹泻患者病毒检测及临床特征分析

Viral etiological and clinical characteristics of infant outpatients with acute diarrhea in Jiangsu,Zhejiang and Fujian

目的分析苏浙闽地区婴幼儿急性腹泻患者常见病毒及患儿临床特征,为婴幼儿急性腹泻的流行病学研究和临床治疗提供参考。方法选取2010至2014年苏浙闽地区多家医院门诊就诊的急性腹泻患儿1 452例,采用ELISA法检测A组轮状病毒(HRV),多重PCR法检测诺如病毒(NoV)、肠道腺病毒(EAdV)和星状病毒(HAstV),并用RT-PCR法对A组轮状病毒阳性的样本进行G和P分型。结果 1 452例患儿中由常见病毒引起的急性腹泻患儿有707例,占总调查患者的48.69%。急性腹泻患儿常见病毒感染中单一病毒感染占90.10%(637/707),其感染病毒的构成以轮状病毒最多(47.52%,336/707),其次为诺如病毒(36.07%,255/707)以及星状病毒(2.40%,17/707)和肠道腺病毒(4.10%,29/707)。病毒感染腹泻患儿中多重感染者共70例,占9.90%(70/707),以A组轮状病毒合并诺如病毒感染最为常见,占多重感染者的68.57%(48/70)。226份A组轮状病毒阳性标本中,G分型以G1为优势分型,占33.19%;P分型中则以P [11]比例最高,占38.50%;G、P型组合以P [11]G11为主(38.50%)。结论 A组轮状病毒是引发婴幼儿急性腹泻的主要病毒,诺如病毒次之,且婴幼儿病毒性腹泻患者可合并多种病毒感染。不同地区腹泻患儿病毒感染阳性率有差异,轮状病毒基因型表现则具有多样性。

Objective To analyze the viral etiological and clinical features of acute viral diarrhea in infant outpatients,and provide reference for the epidemiological study and clinical treatment.Methods 1,452 stool specimens of infantile acute diarrhea in Jiangsu,Zhejiang and Fujian were enrolled since 2010 to 2014.Enzyme-linked immunosorbent assay and multiplex reverse transcription-polymerase chain reaction were used to detect rotavirus(HRV),norovirus(NoV),astrovirus(HAstV)and adenovirus(EAdV).Results 707 of1,452 patients(48.69%)were found infected by at least one common virus.90.10%(637/707)of them were infected by single viral,the proportion of HRV,NoV,HAstV and EAdV was 47.52%(336/707),36.07%(255/707),2.40%(17/707)and 4.10%(29/707),respectively.Meanwhile,70(9.90%,70/707)cases of mixed infections were observed,and 48 of them were rotavirus/norovirus dual infections.G1(33.19%)and P [11](38.50%)were the most prevalent genotypes and P [11]G11(38.50%)was the predominant combination in 226 HRV-positive samples.Conclusion HRV infection is the main virus causing acute diarrhea in infants and young children,followed by NoV;mixed viral infections were common in infant outpatients with acute diarrhea.And the ratio of rotavirus genotypes varied in different years.