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目的探讨新生儿感染轮状病毒(rotavirus,RV)的流行病学情况、临床特征及影响因素,为有效防治新生儿RV感染提供依据。方法采集2011年1月~12月在新疆自治区人民医院新生儿科住院的996例新生儿粪便标本,用胶体金法和酶免法(ELISA)筛查RV,并收集其一般情况和临床资料,应用SPSS17.0对影响其感染RV的因素进行分析。结果 996例患儿中粪便检出RV 94例(9.44%),其中院内感染69例(73.4%)。94例阳性者中24例发生腹泻,11例有喂养困难或呕吐、发热症状,59例为无症状携带者。单因素分析显示不同性别、不同方式分娩的新生儿RV阳性率差异无统计学意义(P>0.05),不同民族(χ2=6.404,P<0.05)、胎龄(χ2=14.309,P<0.01)、出生时体重(χ2=7.074,P<0.05)、出生后天数(χ2=9.576,P<0.01)、喂养方式(χ2=12.517,P<0.01)的新生儿RV阳性率不同。多因素分析显示,早产儿感染率低于足月儿(OR=0.458,95%CI:0.261~0.803,P<0.01);出生后8~21d的新生儿RV阳性率高于7d以内者(OR=2.179,95%CI:1.213~3.912,P<0.01);人工喂养的新生儿RV阳性率高于母乳喂养儿(OR=2.309,95%CI:1.339~3.983,P<0.01)。结论 RV是乌鲁木齐地区新生儿腹泻及院内胃肠道感染的主要病毒病原。足月、出生后2~3周及人工喂养是新生儿易感RV的重要影响因素。制定合理的防控策略,有效预防新生儿RV感染意义重大。
Objective To investigate the epidemiology, clinical features and influencing factors of rotavirus (RV) infection in newborn infants and provide basis for effective prevention and treatment of neonatal RV infection. Methods A total of 996 neonatal stool samples from January 2011 to December 2011 were collected from neonate department of People’s Hospital of Xinjiang Uygur Autonomous Region. The colorectal gold and enzyme immunoassay (ELISA) were used to screen RV and collect general and clinical data. SPSS17.0 analysis of the factors that affect their RV infection. Results In 996 cases, 94 cases (9.44%) of RV were detected in stool samples, among which 69 cases (73.4%) had nosocomial infection. Among the 94 positive cases, 24 cases had diarrhea, 11 cases had difficulty in feeding or vomiting and fever, and 59 cases were asymptomatic carriers. Univariate analysis showed that there was no significant difference in the positive rates of RV among different sexes and births in different ways (χ2 = 6.404, P <0.05), gestational age (χ2 = 14.309, P <0.01) (Χ2 = 7.074, P <0.05), the number of days after birth (χ2 = 9.576, P <0.01), and the positive rate of RV in feeding mode (χ2 = 12.517, P <0.01). Multivariate analysis showed that the positive rate of RV in newborns between 8 and 21 days after birth was significantly higher than that of full-term infants (OR = 0.458, 95% CI: 0.261-0.803, P <0.01) = 2.179, 95% CI: 1.213 ~ 3.912, P <0.01). The positive rate of RV in artificially fed infants was higher than that in breastfeeding children (OR = 2.309, 95% CI: 1.339-3.983, P <0.01). Conclusion RV is the main viral pathogen of neonatal diarrhea and nosocomial gastrointestinal infections in Urumqi. Full-term, 2 to 3 weeks after birth and artificial feeding are important influencing factors for neonatal susceptibility to RV. To develop a reasonable strategy for prevention and control, effective prevention of neonatal RV infection is of great significance.