發(fā)布時(shí)間：2018-03-18 13:10

  本文選題：急性腹瀉　切入點(diǎn)：諾如病毒　出處：《吉林大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:諾如病毒(Norovirus,NoV)是導(dǎo)致兒童病毒性腹瀉的常見(jiàn)病原體,多見(jiàn)于小于5歲兒童。兒童NoV感染性腹瀉常病情重,病程遷延,臨床表現(xiàn)多樣。本研究就我院181例急性腹瀉患兒進(jìn)行NoV病毒感染情況及臨床特點(diǎn)分析,以加強(qiáng)對(duì)此疾病的認(rèn)識(shí),給臨床一定的指導(dǎo)。方法:收集2015年1月~2017年1月在吉林大學(xué)第一醫(yī)院住院,診斷為病毒性腹瀉的患兒的糞便標(biāo)本,提取病毒RNA,逆轉(zhuǎn)錄-聚合酶鏈?zhǔn)椒磻?yīng)(Reverse transcription polymerase chain reaction,RT-PCR)進(jìn)行基因擴(kuò)增,瓊脂糖凝膠電泳(agarose gel electrophoresis,AGE)檢測(cè)諾如病毒。對(duì)患者的臨床資料應(yīng)用軟件SPSS17.0進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:對(duì)收集的181例糞便樣本進(jìn)行檢測(cè),共檢出NoV48例,檢出率26.5%,其中GⅡ46例,GⅠ、GⅡ混合感染2例。NoV感染無(wú)性別差異性,男女比例為1.4:1,冬春季檢出率高,嬰幼兒高發(fā)。臨床癥狀主要有腹瀉(100%)、嘔吐(68.8%)、發(fā)熱(64.6%)、脫水(58%),也可出現(xiàn)腹痛、假性腸梗阻等,部分患兒病程中可伴有呼吸道感染癥狀(35%)。72.9%的患兒存在心肌酶升高,肝功谷丙轉(zhuǎn)氨酶異常者少見(jiàn)。兒童NoV感染預(yù)后良好:治愈出院占35.42%(17/48),好轉(zhuǎn)出院64.58%(31/48),住院中位數(shù)為6天。結(jié)論:1.GⅡ型為兒童主要NoV感染病毒株。2.兒童NoV感染無(wú)明顯性別差異,具有季節(jié)性,以冬春季為主,3歲以下嬰幼兒為高發(fā)人群。3.兒童NoV感染的主要臨床表現(xiàn)為腹瀉、發(fā)熱、嘔吐、脫水,也可有呼吸道感染癥狀。72.9%患兒出現(xiàn)心肌酶CK-MB升高,肝功ALT異常者少見(jiàn)。4.NoV感染目前無(wú)特效治療,以支持對(duì)癥為主,預(yù)后良好。
[Abstract]:Objective: Norovirus-Nov) is a common pathogen causing viral diarrhea in children, which is more common in children under 5 years of age. NoV infective diarrhea in children is often severe and the course of disease is prolonged. In this study, 181 cases of acute diarrhea in our hospital were analyzed for NoV virus infection and clinical characteristics, in order to strengthen the understanding of this disease, Methods: from January 2015 to January 2017, the fecal specimens of children with viral diarrhea were collected from the first Hospital of Jilin University. Virus RNAs were extracted, reverse transcription polymerase chain reactionation reverse transcriptase polymerase chain reaction (RT-PCR) was used for gene amplification. Agarose gel electrophoresis-AGEA was used to detect Norovirus. The clinical data of the patients were analyzed statistically by SPSS17.0. Results: 181 stool samples were detected and NoV48 cases were detected. The detection rate was 26.5%. There was no sex difference in G 鈪，

本文編號(hào)：1629712