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目的了解天津市轮状病毒(RV)腹泻发病状况,以及临床及流行病学特征。方法在天津市不同区域设立5所医院,对就诊的感染性腹泻患者按设计的调查内容做现场调查、采集粪便标本,采用ELISA方法检测RV抗原,并以RT-PCR方法做型别分析。结果 1 085例患者中207例检出RV抗原,阳性率为19.08%,其中≤5岁患者的阳性率达32.20%。基因型以G3、G1及P[8]为主,分别占31.88%、17.87%和25.12%。感染存在区域间的聚集性,秋冬季高发。散居儿童患者的阳性率达31.85%。患者发病到初诊平均为(1.63±5.03)d,39.65%在发病当天就诊。RV腹泻患者每日腹泻的次数明显多于非RV腹泻患者,且多为水样便。便常规检测RV腹泻患者的白细胞数均≤10/HPF。患者的年龄、性别、饮食等卫生习惯经Logistic逐步回归分析,变量均无统计学意义。结论天津市感染性腹泻患者19.08%为RV所致,≤5岁患者更是多达32.20%,已经成为公共卫生问题。RV感染的危险因素与非RV腹泻患者类似。
Objective To understand the incidence of rotavirus (RV) diarrhea in Tianjin and its clinical and epidemiological characteristics. Methods Five hospitals were set up in different areas of Tianjin. Field investigation was conducted on the surveyed patients with infectious diarrhea. Stool specimens were collected and RV antigen was detected by ELISA. Type analysis was performed by RT-PCR. Results Of the 1 085 cases, 207 cases were detected RV antigen, the positive rate was 19.08%, of which ≤5 years old patients with a positive rate of 32.20%. The genotypes were mainly G3, G1 and P [8], accounting for 31.88%, 17.87% and 25.12% respectively. Infection exists between the regional aggregation, high in autumn and winter. The positive rate of diaspora patients was 31.85%. The average number of patients with newly diagnosed onset was (1.63 ± 5.03) d, 39.65% were on the day of onset. Patients with RV diarrhea daily diarrhea significantly more than non-RV diarrhea patients, and mostly watery stools. They routinely detect RV diarrhea in patients with leukocytes were ≤ 10 / HPF. Patient age, gender, diet and other hygiene habits by Logistic stepwise regression analysis, the variables were not statistically significant. Conclusion 19.08% of patients with infectious diarrhea in Tianjin are caused by RV, and up to 32.20% of patients ≤5 years old have become public health problems. The risk factors for RV infection are similar to those in non-RV diarrhea.