本文選題：諾如病毒　切入點：急性胃腸炎　出處：《實用醫(yī)學雜志》2015年19期

【摘要】：目的:分析社區(qū)獲得性散發(fā)諾如病毒性胃腸炎的臨床特征,為該疾病診治提供幫助。方法:選擇2012年8月至2013年7月就診于宣武醫(yī)院腸道門診擬診感染性腹瀉的患者519例,對患者的性別、年齡、發(fā)病月份及臨床癥狀如發(fā)熱、腹痛、腹瀉及嘔吐的次數(shù)等進行觀察和記錄。同時檢測血常規(guī)及便常規(guī),對糞便標本進行諾如病毒的核酸檢測,并對基因序列測序分型。結(jié)果:腹瀉病例519例,諾如病毒陽性患者136例(26.20%)。共分離諾如病毒140株,16個基因型為6個GⅠ型和10個GⅡ型,其中GⅡ-4 2006b 71例。老年患者患病率明顯增高(P=0.021),諾如病毒感染患者易出現(xiàn)嘔吐癥狀[60.29%(82/136)vs.43.08%(165/383),P=0.001],諾如病毒患者出現(xiàn)中性粒細胞的比例增高[63.97%(87/136)vs.54.56%(209/383),P=0.034],大便常規(guī)的鏡檢存在紅、白細胞在諾如病毒感染患者低[16.18%(22/136)vs.27.42%(105/383),P=0.009]。GⅡ型在老年患者的發(fā)病明顯高于GⅠ型(P=0.025)。結(jié)論 :GⅡ-4 2006b型諾如病毒是社區(qū)獲得性散發(fā)諾如病毒性胃腸炎的主要病原體,其臨床具有一定的特殊性,老年患者GⅡ型諾如病毒患病率較高。
[Abstract]:Objective: to analyze the clinical characteristics of community-acquired sporadic noroviral gastroenteritis and to provide help for the diagnosis and treatment of the disease. Methods: 519 patients with infectious diarrhea were selected from August 2012 to July 2013. The patient's sex, age, month of onset and clinical symptoms such as fever, abdominal pain, diarrhea and vomiting were observed and recorded. Blood routine and stool routine were also detected. Results: 519 cases of diarrhea and 136 cases of norovirus positive patients were isolated 140 strains of Norovirus, 16 genotypes were 6 G 鈪，

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