本文選題：新生兒 + 腸道病毒��； 參考：《吉林大學》2012年碩士論文

【摘要】：目的：本研究旨在探討新生兒腸道病毒感染的臨床特點與病原學的相關性，特別是腸道病毒71型（EV71）、柯薩奇A組16型（CoxA16）、�？刹《�30型（E30）及副�？刹《驹谛律鷥褐械母腥厩闆r；并了解其感染的臨床特點及季節(jié)、年齡和性別的分布情況，以便早診斷、早隔離、早治療。方法：采集2011年1月-12月584例新住院的新生兒的糞便標本，用逆轉錄－聚合酶鏈反應（RT-PCR）檢測EV通用型、EV71、CoxA16、E30及副埃可病毒，出院時（住院14天），對部分腸道病毒感染的患兒再次檢查EV通用型；同時采血進行血常規(guī)、血糖、肝功能、心肌酶等檢查；并對臨床資料進行分析。結果：2011年長春市兒童醫(yī)院新生兒糞便標本腸道病毒通用型陽性檢出率為11.98%（70/584），其中EV71陽性檢出率為11.43%（8/70），CoxA16、E30和副�？刹《揪礄z出；EV感染的季節(jié)分布，發(fā)病高峰月份為7～8月；性別分布：男女之比1.5：1；年齡分布：發(fā)病高峰年齡為20～28日齡；臨床癥狀發(fā)熱41例，58.57%；腹瀉40例，57.14%；拒乳10例，14.29%；嘔吐12例，17.14%；皮疹23例，32.86%；心肌損害（心電圖心肌缺血、心肌酶增高）29.41%；神經系統(tǒng)并發(fā)癥（驚跳/震顫/拒乳/嗜睡）22.86%，呼吸系統(tǒng)并發(fā)癥（支氣管炎、支氣管肺炎）55.71%。復查的22例腸道病毒感染的患兒，EV通用型仍為陽性20例，陰性2例。EV71感染患兒，發(fā)熱100%；皮疹6例，75%，皮疹為細小紅色皮疹，3天左右消失，不留痕跡，，與嬰幼兒手足口病例皮疹特點不同；所有患兒經治療，均臨床治愈出院，平均住院天數(shù)為8.83±1.79天。結論：1、新生兒中存在腸道病毒感染，2011年主要為EV71型感染；2、新生兒腸道病毒感染有明顯季節(jié)性（7～8月份）；3、新生兒腸道病毒感染存在明顯的高發(fā)年齡段（20-28日齡）；4、新生兒腸道病毒感染，主要表現(xiàn)為腹瀉、發(fā)熱、皮疹、循環(huán)障礙、心肌損害等表現(xiàn)，EV71感染患兒發(fā)熱比例高；5、新生兒腸道病毒感染2周仍通過便中排毒。
[Abstract]:Objective: to investigate the relationship between the clinical characteristics and etiology of enterovirus infection in neonates, especially the infection of enterovirus 71, Coxsackie A group 16 (CoxA16), E30 (E30) and paracoviruses in neonates. The clinical characteristics, season, age and sex distribution of the infection were also investigated for early diagnosis, early isolation and early treatment. Methods: fecal specimens of 584 newborns from January to December 2011 were collected and detected by reverse transcription-polymerase chain reaction (RT-PCR). At the time of discharge (14 days in hospital, the children with partial enterovirus infection were re-examined for EV universal type; blood samples were collected for blood routine examination, blood glucose, liver function, myocardial enzyme and so on; and the clinical data were analyzed. Results: in 2011, the positive rate of enterovirus in fecal specimens of newborns in Changchun Children's Hospital was 11.98 / 584%, and the positive rate of EV71 was 11.43 / 80 / 70 CoxA16 / E30 and E30 respectively, and the seasonal distribution of EV infection was not detected, and the peak was from July to August. Sex distribution: male / female ratio 1.5: 1; Age distribution: peak onset age of 20 to 28 days; clinical symptoms fever 41 cases 58.57; diarrhea 40 cases 57.14; rejected breast 10 cases 14.29; vomiting 12 cases 17.14; rash 23 cases 32.86; myocardial damage (electrocardiogram myocardial ischemia) Myocardial enzymes increased 29.41%, nervous system complications (thrill / tremor / milk rejection / sleepiness 22.86), respiratory system complications (bronchitis, bronchopneumonia 55.71%), respiratory complications (bronchitis, bronchopneumonia, bronchitis, bronchopneumonia). In 22 cases of enterovirus infection, the common type of EV was still positive in 20 cases, negative in 2 cases, and fever in 100 cases. The characteristics of rash were different from those of infants with hand, foot and mouth disease, all the children were cured and discharged from hospital after treatment, the average hospital stay was 8.83 鹵1.79 days. Conclusion there is intestinal virus infection in newborns, mainly EV71 type 2 infection in 2011. There are significant seasonal enterovirus infections in neonates in August of July and August. There is a significant high incidence of enterovirus infection in neonates at 20 to 28 days of age, and enterovirus infection in newborns. The main manifestations were diarrhea, fever, rash, circulatory disturbance, myocardial damage, etc. The rate of fever was 5% higher in children with EV71 infection. The infection of neonatal enterovirus was still detoxified in feces for 2 weeks.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R725.1

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