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目的了解婴幼儿急性腹泻的病原构成,为本地区临床合理有效地控制小儿急性腹泻提供病原依据。方法对2009年1-12月福州儿童医院消化专科收治的459例急性腹泻患儿的粪便标本进行细菌培养,采用免疫胶体金法检测轮状病毒(RV)抗原;抽取其中218例,再应用ELISA法检测RV抗原,逆转录聚合酶链式反应(RT-PCR)法检测诺如病毒(NV)核酸。结果 459例患儿细菌感染35例(7.6%),真菌感染5例(1.1%),检出RV阳性117例(25.5%)。218例中RV阳性69例(31.7%),NV阳性61例(28.0%),上述二种病毒混合感染14例(6.4%)。两种病毒感染阳性率男女性别差异无统计学意义(P>0.05),不同年龄组间RV及NV阳性率差异有统计学意义(P<0.05),均以2岁以下患儿为主。RV、NV均有明显的季节特征,RV以10-12月份为发病高峰,NV以7~9月份为发病高峰分布,差异均有统计学意义(P<0.05)。结论小儿感染性腹泻病原类型复杂多样,在临床诊治中应重视病原学检测。
Objective To understand the pathogensis of acute diarrhea in infants and young children and to provide pathogenic basis for the reasonable and effective control of pediatric acute diarrhea in this area. Methods Bacteria were cultured in 459 cases of acute diarrhea admitted to Department of Gastroenterology, Fuzhou Children’s Hospital from January to December 2009. The antigen of rotavirus (RV) was detected by immunogold method. 218 RV antigen was detected by PCR and Norovirus (NV) nucleic acid was detected by reverse transcription-polymerase chain reaction (RT-PCR). Results Among 459 cases, 35 cases (7.6%) had bacterial infection, 5 cases (1.1%) had fungal infection, and 117 cases (25.5%) had positive RV test. In 218 cases, 69 cases were positive for RV (31.7%), 61 cases were positive for NV (28.0%), and 14 cases (6.4%) were mixed infection of the above two kinds of viruses. There was no significant difference in the positive rates of the two viruses between male and female (P> 0.05). The positive rates of RV and NV in different age groups were statistically significant (P <0.05), both of which were mainly in children under 2 years old. RV and NV all had obvious seasonal characteristics. RV peaked from October to December, and NV peaked from July to September. The difference was statistically significant (P <0.05). Conclusion The types of infectious diarrhea in children are complex and diverse. Etiological detection should be emphasized in clinical diagnosis and treatment.