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目的探讨5岁以下婴幼儿轮状病毒(RV)腹泻发病的危硷因素,为该病的预防控制提供科学依据。方法选择深圳某街道2007年10月—2009年12月,5岁以下的RV实验室确诊病例166例作为病例组,按照1∶1匹配随机选择同期未出现呕吐或腹泻症状,且与确诊病例同一或相邻楼层、相同性别、相同月龄段者作为对照。自行设计问卷,由统一培训的调查员对儿童家长进行面访调查,收集相关信息。采用EPI INFO 3.3软件建立数据库,然后使用SPSS 13.0软件包进行统计分析。结果 166例病例中,腹泻占98.80%(164/166),发热(≥37.5℃)的占55.42%(92/166),呕吐的占48.80%(81/166)。曾口服RV疫苗的56例病例中,服苗14 d内发病的占32.14%(18/56),服苗超过1年后发病的占58.93%(33/56)。单因素条件logistic回归分析结果显示,接触过呕吐(腹泻)病人和到过某医院门诊部的是危险因素,口服RV疫苗、母乳喂养和喂孩子之前洗手是保护因素(均P<0.05)。口服RV疫苗的疫苗效力(VE)=(1-0.57)×100%=43%。多因素条件logistic回归分析结果显示,接触过呕吐(腹泻)病人是危险因素,口服RV疫苗每年二三次和喂孩子之前洗手是保护因素(均P<0.05)[1]。口服RV疫苗2次/a的VE=(1-0.48)×100%=52%;口服RV疫苗3次/a的VE=(1-0.35)×100%=65%。结论腹泻、发热、呕吐是轮状病毒感染主要的症状;口服RV疫苗需要经过2周后方可产生抗体,免疫力只能维持1 a;避免接触呕吐(腹泻)病人,每年口服RV疫苗二三次和喂孩子之前洗手等可减少感染RV。
Objective To investigate the risk factors of rotavirus (RV) diarrhea in infants and children under 5 years old, and provide a scientific basis for the prevention and control of this disease. Methods Select a street in Shenzhen 2007 October -2009 December, RV laboratories under the age of 5, 166 cases were diagnosed as case group, according to the 1: 1 match randomly selected over the same period did not vomit or diarrhea symptoms, and confirmed the same case Or adjacent floors, the same gender, the same age group as a control. Self-designed questionnaire, unified training of investigators interviewed children’s parents to collect relevant information. EPI INFO 3.3 software to establish a database, and then use SPSS 13.0 software package for statistical analysis. Results Among 166 cases, diarrhea accounted for 98.80% (164/166), fever (≥37.5 ℃) accounted for 55.42% (92/166) and vomiting accounted for 48.80% (81/166). Among 56 cases of oral administration of RV vaccine, 32.14% (18/56) of the patients took the vaccine within 14 days and 58.93% (33/56) of the patients who took the vaccine more than one year later. Univariate conditional logistic regression analysis showed that patients who had been exposed to vomit (diarrhea) and had been to a hospital outpatient department were risk factors. Oral RV vaccine, breastfeeding and hand washing before feeding were protective factors (all P <0.05). Vaccine efficacy of oral RV vaccine (VE) = (1-0.57) × 100% = 43%. Multivariate conditional logistic regression analysis showed that patients who had been exposed to vomiting (diarrhea) were risk factors. Oral RV vaccine was a protective factor (both P <0.05) two or three times a year and hand washing before feeding to children [1]. VE = (1-0.48) × 100% = 52% for oral RV vaccine 2 times / a; VE = (1-0.35) × 100% = 65% for oral RV vaccine 3 times / a. Conclusions Diarrhea, fever and vomiting are the main symptoms of rotavirus infection. Oral RV vaccine takes 2 weeks to produce antibody, and its immunity can only be maintained for 1 year. Avoid contact with vomiting (diarrhea) patients and oral RV vaccine twice or three times a year Wash your hands before feeding your child to reduce RV infection.