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[目的]对56例散发性诺如病毒性胃肠炎患者的流行病学特征和临床特征进行分析,为该疾病的防治提供帮助。[方法]从2007年12月10日~2008年1月10日连续抽取病例100例,以呕吐或腹泻等消化道症状为主诉就诊的门诊病例,发病3d以内的病例,每周从周一开始,每周连续抽取20个满足上述定义的病例。对收集病例进行流行病学调查如临床症状、可疑危险因素、用药情况、血常规、便常规进行监测,同时用ELISA方法对粪便标本进行诺如病毒检测。[结果]100例监测病例中56例占56%感染诺如病毒。感染患者的性别、年龄、职业、文化程度等与未感染诺如病毒患者比较差异无统计学意义(P﹥0.05),但感染者中以中青年为主49例占87.5%。临床症状的发生诺如病毒性胃肠炎患者更易出现腹痛(χ2=4.058,P=0.044),其他症状如腹泻、恶心、呕吐、发热等与未感染诺如病毒患者差异无统计学意义(P﹥0.05);实验室检查结果血常规中性粒细胞的变化差异有统计学意义(χ2=5.628,P=0.018),白细胞和淋巴细胞的变化差异无统计学意义(P﹥0.05),便常规镜检红、白细胞两组差异有统计学意义(χ2=5.031,P=0.025),感染诺如病毒患者3例占5.35%诊断急性细菌性痢疾。多数患者给予对症治疗3d恢复,考虑合并细菌感染患者给予抗生素治疗3～7d恢复。[结论]诺如病毒是冬季散发性急性胃肠炎的主要病原体,可能易合并细菌感染,使用对症、抗生素治疗可痊愈。
[Objective] To analyze the epidemiological characteristics and clinical features of 56 patients with sporadic Norovirus gastroenteritis and provide help for the prevention and treatment of this disease. [Methods] From December 10, 2007 to January 10, 2008, 100 consecutive cases were drawn, outpatient visits were conducted mainly with gastrointestinal symptoms such as vomiting or diarrhea, cases within 3 days after onset, every week from Monday, Twenty consecutive cases were selected each week to meet the above definition. Epidemiological investigation of the collected cases such as clinical symptoms, suspicious risk factors, medication, blood routine, they routinely monitor, while using the ELISA method for Norovirus detection of stool specimens. [Results] Of the 100 cases monitored, 56 cases were infected with norovirus. There was no significant difference in the gender, age, occupation, educational level, etc. of infected patients compared with those without norovirus infection (P> 0.05). However, 49 cases were mainly middle-aged and young with infection, accounting for 87.5%. Clinical symptoms occurred in patients with norovirus gastroenteritis more likely to have abdominal pain (χ2 = 4.058, P = 0.044), other symptoms such as diarrhea, nausea, vomiting, fever and no norovirus infection in patients with no significant difference (P > 0.05). The results of laboratory tests showed that there were significant differences in the changes of blood routine neutrophils (χ2 = 5.628, P = 0.018), no significant difference in the changes of leukocytes and lymphocytes (P> 0.05) There was a significant difference between the two groups (χ2 = 5.031, P = 0.025). Three cases of Norovirus infected patients accounted for 5.35% of cases diagnosed with acute bacillary dysentery. The majority of patients given symptomatic treatment 3d recovery, considering bacterial infection in patients with antibiotic treatment 3 ~ 7d recovery. [Conclusion] Norovirus is the main pathogen of sporadic acute gastroenteritis in winter, which may be easily combined with bacterial infection and symptomatic treatment. The antibiotic treatment can be cured.