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目的了解天津市诺如病毒(NV)腹泻发病状况及其临床和流行病学特征。方法在天津市不同区域设立5所医院,对就诊的成人和儿童其他感染性腹泻(除霍乱、细菌性和阿米巴性痢疾、伤寒和副伤寒以外的感染性腹泻)患者按设计的调查内容现场询问获得资料,同时收集患者粪便标本,采用ELISA方法检测NV抗原,并以RT-PCR方法做型别分析。结果 1 085例患者中129例检出NV抗原,阳性率为11.89%,其中≤5岁患者的阳性率达23.05%(68/295)。基因型以GⅡ为主,占80.62%(104/129)。感染不存在区域间的聚集性,冬春季节高发。散居儿童患者的阳性率达22.60%(66/292)。患者在发病15d内就诊可以检测出诺如病毒。NV腹泻患者每日腹泻的次数明显多于非NV腹泻患者,且多为水样便。便常规检测97.25%(813/836)的NV腹泻患者的白细胞数≤10/高倍镜视野(400倍)。结论天津市其他感染性腹泻患者中11.89%为NV所致,≤5岁患者该比例更高达23.05%,这已成为一个公共卫生问题。
Objective To understand the status of Norovirus (NV) diarrhea in Tianjin and its clinical and epidemiological characteristics. Methods A total of 5 hospitals in different districts of Tianjin were designed according to the survey designed for patients with other infectious diarrhea (other than cholera, bacterial and amebic dysentery, typhoid and paratyphoid other than infectious diarrhea) in adults and children On-site access to information obtained at the same time collecting the patient stool specimens, ELISA method for detection of NV antigen, and RT-PCR method for type analysis. Results Of the 1 085 cases, 129 cases were detected with NV antigen, the positive rate was 11.89%, of which the positive rate was 23.05% (68/295). Genotype G Ⅱ, accounting for 80.62% (104/129). Infection does not exist between the regional aggregation, high in winter and spring. The positive rate of diaspora was 22.60% (66/292). Patients within 15 days of onset of treatment can detect norovirus. NV diarrhea patients daily diarrhea significantly more than non-NV diarrhea patients, and mostly watery stools. We routinely detected 97.25% (813/836) of NV diarrhea patients with white blood cell count ≤10 / high magnification (400 times). Conclusion 11.89% of patients with other infectious diarrhea in Tianjin are caused by NV, and this proportion is as high as 23.05% in patients ≤ 5 years old, which has become a public health issue.