婴幼儿轮状病毒感染致肠外损害的临床研究

Clinical study of extra intestinal damage after rotavirus infection in infants

目的 探讨婴幼儿轮状病毒感染致肠外脏器损害的状况,分析可能引起肠外脏器损害的相关危险因素以及降钙素原(procalcitonin,PCT)在多脏器损害中的临床意义.方法 选取103例轮状病毒感染患儿(感染组)和同时期的65例非感染的急性腹泻患儿(对照组),比较两组患儿肠外脏器损害的情况;同时对轮状病毒感染后可能引起肠外脏器损害的相关危险因素进行分析,分析血清PCT与多脏器损害的关系.结果 感染组罹患呼吸道感染、心肌损害以及肝脏损害的发生率明显高于对照组(P＜0.05).高热是心肌损害的高危因素.而PCT水平在多脏器损害组中明显高于未损害组以及仅有一个脏器损害组(P＜0.05).结论 轮状病毒感染易引起肠道外的脏器损害;高热是心肌损害的高危因素;而PCT的升高提示轮状病毒感染可能引起肠外多个脏器功能损害.

Objective To investigate the incidence of extra intestinal organ damage in infants with acute rotavirus (RV) infection,the relative risk factors in patients with extra intestinal organ damage,the significance of procalcitonin(PCT)in those infants with multiple organ injury.Methods One hundred and three infants with acute diarrhea whose rotavirus antigens were positive and 65 negative ones were divided into two groups.The differences between these two groups in incidences of extra intestinal organ damage were analyzed.Meanwhile,variables from the clinical data that may lead to extra intestinal organ damage were analyzed.Then,the relationship of multiple organ damage and serum concentration of PCT was also analyzed.Results There were significant differences between positive group and negative group in the rates of respiratory system injury,myocardial damage and hepatic involvement (P ＜ 0.05).High fever was the only high risk factor in myocardial damage through multi factor Logistic regression analysis.There were also significant differences among the group with multiple organ damage and only one extra intestinal organ damage and no extra intestinal organ damage in serum concentration of PCT(P ＜ 0.05).Conclusion It is common to be attacked by extra intestinal organ damage in infants with acute rotavirus infection.High fever is the risk factor for RV enteritis complicated with myocardial damage.The elevation of PCT concentration suggest that multiple organ injury out of the intestinal tract may take place in infants with acute RV infection.