惠東地區(qū)兒童社區(qū)獲得性輪狀病毒感染流行病學(xué)研究

鄧正銘 劉立馗 翁志他

【摘要】 目的：本文主要對(duì)惠東地區(qū)兒童社區(qū)獲得性輪狀病毒感染的流行病學(xué)特征進(jìn)行研究，為臨床診療和疫苗研制提供重要的理論依據(jù)。方法：選取筆者所在醫(yī)院2018年3月-2019年3月社區(qū)獲得性感染腹瀉患兒共2 286例作為研究對(duì)象，采集患兒的新鮮糞便作為標(biāo)本，進(jìn)行輪狀病毒抗原檢測(cè)，并使用免疫層析雙抗體夾心法（膠體金法）和RT-PCR法進(jìn)行G血清分型檢測(cè)，分析其流行病學(xué)特征并掌握輪狀病毒流行株。結(jié)果：2 286例標(biāo)本中輪狀病毒陽(yáng)性檢出1 016例，陽(yáng)性檢出率為44.4%，不同性別患兒的輪狀病毒感染腹瀉檢出率差異無(wú)統(tǒng)計(jì)學(xué)意義（字2=0.04，P=0.979）;發(fā)病年齡主要集中在5個(gè)月～3歲的患兒，與>3歲且≤5歲年齡段比較，差異有統(tǒng)計(jì)學(xué)意義（字2=27.99，P=0.000）;流行季節(jié)高峰為秋冬季（即9月至次年2月份），其主要臨床癥狀以稀水樣便為主，常伴有發(fā)熱、嘔吐、脫水等。引起輪狀病毒感染的危險(xiǎn)因素主要有吮指習(xí)慣、陪護(hù)人員衛(wèi)生意識(shí)差、進(jìn)食不健康物品、不良的清潔習(xí)慣、兒童護(hù)理知識(shí)水平低下、未按時(shí)進(jìn)行疫苗接種等;在G血清分型檢測(cè)上顯示，G3型患兒人數(shù)最多，為流行株型號(hào);G1次之。結(jié)論：輪狀病毒感染是筆者所在縣5歲以下兒童急性腹瀉的主要致病因素之一，秋冬季為高發(fā)季節(jié)，主要感染病毒流行株為G3型和G1型，其危險(xiǎn)因素主要與不良衛(wèi)生習(xí)慣、兒童護(hù)理知識(shí)不全面等因素密切相關(guān)，臨床醫(yī)護(hù)人員應(yīng)當(dāng)予以重視，通過(guò)掌握其流行病學(xué)特征，設(shè)定針對(duì)性的診療計(jì)劃，并做好相應(yīng)健康指導(dǎo)。

【關(guān)鍵詞】 惠東地區(qū) 兒童輪狀病毒感染 流行病學(xué)研究

doi：10.14033/j.cnki.cfmr.2020.08.071??文獻(xiàn)標(biāo)識(shí)碼 B??文章編號(hào) 1674-6805（2020）08-0-03

Epidemiological Study on Community Acquired Rotavirus Infection in Children in Huidong District/DENG Zhengming， LIU Likui， WENG Zhita. //Chinese and Foreign Medical Research， 2020， 18（8）： -171

[Abstract] Objective： To study the epidemiological characteristics of community acquired rotavirus infection in children in Huidong district， and to provide important theoretical basis for clinical diagnosis and treatment and vaccine development selection. Method： From March 2018 to March 2019， 2 286 children with diarrhea in our hospital during community acquired infections were selected as the research object， the fresh dejection as specimens of children with rotavirus antigen detection were collected， and double antibody immune chromatography clip art （colloidal gold） and RT-PCR method for G serotyping detection were used to analyzed the epidemiological characteristics and master the rotavirus epidemic strains. Result： There were 1 016 positive rotavirus infection specimens， with a positive rate of 44.44%. There was no statistically significant difference in the detection rate of rotavirus infection diarrhea in infants of different genders （字2=0.04， P=0.979）. The age of onset was mainly 5 months to 3 years old， compared with above 3 to 5 years old， there was significant difference （字2=27.99， P=0.000）. The high incidence of rotavirus infection occurred in autumn （September， October and November） and winter （December， January and February）. The clinical symptoms of rotavirus infection mainly include fever， vomiting， dehydration， upper respiratory tract infection， etc. The main risk factors for rotavirus infection were finger sucking habits， poor health awareness of caregivers， unhealthy food， poor cleaning habits， and delayed vaccination， etc. The G blood typing test showed that the number of patients with G3 type was the largest， which was the popular strain G1. Conclusion： Rotavirus infection is one of the main causes of diarrhea in children in huidong area. The incidence of diarrhea is high in autumn and winter， and the main epidemic strains of rotavirus are G3 and G1. The risk factors are closely related to the bad health habits and the incomplete knowledge of childrens nursing. The clinical medical staff should pay attention to it， set up the targeted diagnosis and treatment plan， and do a good job of health guidance by mastering its epidemiological characteristics.