發(fā)布時(shí)間：2018-04-17 00:11

  本文選題：腹瀉病 + 輪狀病毒��； 參考：《蚌埠醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的調(diào)查5歲以下住院腹瀉病患兒A組輪狀病毒(rotavirus RV)感染流行狀況,比較分析其臨床特征,從而更加深入地了解RV感染特征,為制定RV防治策略提供基礎(chǔ)資料。方法收集蚌埠醫(yī)學(xué)院第一附屬醫(yī)院2014-2015年5歲以下因急性腹瀉而住院的患兒資料,膠體金法檢測(cè)糞便A組RV抗原,對(duì)不同月份、年齡組、性別RV感染情況進(jìn)行調(diào)查,并根據(jù)RV檢測(cè)結(jié)果將腹瀉患兒分RV陽(yáng)性組和RV陰性組,對(duì)2組的臨床特征包括腹瀉、嘔吐、脫水、發(fā)熱、神經(jīng)系統(tǒng)損害、呼吸道感染、嚴(yán)重程度及相關(guān)的實(shí)驗(yàn)室檢測(cè),包括乳酸脫氫酶(lactate dehydrogenase,LDH)、肌酸激酶(creatine kinase,CK)、肌酸肌酶同工酶(creatine kinase isoenzyme,CK-MB)、天門(mén)冬氨酸轉(zhuǎn)氨酶(aspartate transaminase,AST)、丙氨酸轉(zhuǎn)氨酶(alanine transaminase,ALT)等情況進(jìn)行比較分析。結(jié)果(1)共850例患兒,301例RV陽(yáng)性,總的RV感染率為35.41%;RV感染性腹瀉全年均可發(fā)病,10-12月為RV感染的高峰期;不同年齡組RV感染率差異有統(tǒng)計(jì)學(xué)意義(χ2=80.993,P0.05);12-18月組感染率最高,為53.91%,總體上,RV陽(yáng)性患兒中有265例(88%)為小于18個(gè)月;RV感染率男女性別間無(wú)顯著性差異(χ2=0.375,P0.05)。(2)住院腹瀉病患兒中RV陽(yáng)性者比RV陰性者更易發(fā)生水樣便(χ2=14.570,P0.001)、嚴(yán)重腹瀉(χ2=5.931,P0.05)、嘔吐(χ2=66.093,P0.001)、脫水(χ2=45.003,P0.001)、呼吸道感染(χ2=11.829,P0.05),差異有統(tǒng)計(jì)學(xué)意義。(3)與非RV感染性腹瀉患兒相比較,RV感染性腹瀉病兒童呈較高的Vesikari得分,差異有統(tǒng)計(jì)學(xué)意義(t=4.937,P0.001);RV陽(yáng)性腹瀉患兒組,重型腹瀉發(fā)生率高于RV陰性腹瀉患兒組,差異有統(tǒng)計(jì)學(xué)意義(χ2=21.430,P0.001)。(4)RV陽(yáng)性組的LDH、CK、CK-MB、AST、ALT明顯高于RV陰性組,差異有統(tǒng)計(jì)學(xué)意義(LDH:t=4.105,P0.001;CK:t=2.060,P0.05;CK-MB:t=5.463,P0.001;AST:t=3.423,P0.05;ALT:t=4.339,P0.001)。結(jié)論(1)RV感染是5歲以下兒童腹瀉的重要原因,RV感染高峰發(fā)生在干冷的秋冬季,其感染率呈顯著的年齡差異。(2)RV感染性腹瀉病更易伴有水樣便、嚴(yán)重腹瀉、嘔吐癥狀及腸外癥狀如脫水、呼吸道感染。(3)RV感染性腹瀉比未感染RV的腹瀉臨床癥狀重。(4)RV感染對(duì)心肌及肝臟有一定程度的影響。應(yīng)重視并加強(qiáng)RV感染的防治。
[Abstract]:Objective to investigate the prevalence of group A rotavirus rotavirus (RV) infection in children under 5 years of age, and to compare and analyze its clinical characteristics, so as to understand the characteristics of RV infection more deeply and provide basic data for the formulation of RV prevention and treatment strategy.Methods the data of children under 5 years of age who were hospitalized for acute diarrhea in the first affiliated Hospital of Bengbu Medical College from 2014 to 2015 were collected. The RV antigen in feces of group A was detected by colloidal gold method. The infection of RV in different months, age groups and sex was investigated.According to the results of RV test, children with diarrhea were divided into RV positive group and RV negative group. The clinical features of the two groups included diarrhea, vomiting, dehydration, fever, nervous system damage, respiratory tract infection, severity and related laboratory tests.Among them, lactate dehydrogenase, creatine kinase, creatine kinase isoenzyme, aspartate transaminase and alanine transaminase ALT were compared and analyzed.Results there were 301 cases of RV positive in 850 children, the total RV infection rate was 35.41%, the peak of RV infection was from October to 12 months, the difference of RV infection rate among different age groups was statistically significant (蠂 2 / 80.993P0.05 / 18 months), the infection rate of RV infection was the highest in the group of 12 to 18 months (蠂 2 / 80.993P 0.05 / 18), and the infection rate of RV infection was the highest in different age groups.There was no significant difference between male and female patients with RV infection rate less than 18 months (蠂 2: 0.375%, P 0.05%. 2) the patients with RV positive were more likely to develop water stool than those with RV negative (蠂 214.570 P 0.001), severe diarrhea (蠂 25.931 P 0.05, P 0.005), vomiting (蠂 2 6.093P 0.001, P 0.001).Compared with non-RV infective diarrhea, dehydration (蠂 2 + 45.003), respiratory tract infection (蠂 2 + 11.829% P 0.05) and non-RV infective diarrhea (P 0.001) had a higher Vesikari score than that of non-RV infective diarrhea.Conclusion RV infection is an important cause of diarrhea in children under 5 years of age. The peak of RV infection occurs in dry and cold autumn and winter. The infection rate of RV is significantly different in age. RV infection is more likely to be accompanied by water stool and severe diarrhea.Vomiting and extraintestinal symptoms such as dehydration, respiratory tract infection, respiratory tract infection, RV infection were more severe than those without RV infection.The prevention and treatment of RV infection should be emphasized and strengthened.
【學(xué)位授予單位】：蚌埠醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R725.1;R181.3

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