北京地区2007年儿童A群轮状病毒腹泻的流行病学研究

目的 研究北京地区急性腹泻儿童中A群轮状病毒(RV)感染的流行病学特点.方法 收集2007年4月至12月我院肠道门诊就诊的2039例急性腹泻患儿的粪便标本,采用标记金的A群RV单克隆抗体,以免疫层析双抗体夹心法定性检测A群RV抗原.结果 2039份粪便标本中,621份检测到A群RV,总检出率为30.5%(621/2039),其中男430例(69.2%),女191例(30.8%).RV感染者中,以6个月～2岁年龄段的患儿为最多,共571例(91.9%).检出率以10～12月份最高,均在30%以上,其中高峰出现在11月份,达43.4%.北京地区18个区县的统计数据显示,距市区较近的区县RV抗原检出率较低,边远区县较高.少部分患儿合并肠道细菌感染.结论 A群RV为北京地区2岁以下儿童急性腹泻病的主病原,6个月～2岁婴幼儿是A群RV的易感人群,10～12月份为北京地区的流行高峰.在流行季节对肠道细菌感染患儿常规进行A群RV抗原检测有助于避免漏诊和进行更合理的治疗.

Cluster A rotavirus diarrhea in children in Beijing in 2007

Objective To investigate the epidemiologic features of cluster A rotavirus (RV) infection among children with acute diarrhea in Beijing. Methods Stool specimens were collected from 2 039 outpatients with acute diarrhea in the intestine clinic of Beijing Children's Hospital Affiliated to Capital Medical University from April to December 2007. The cluster A RV antigen was detected in the stool specimens by the qualitative technique of colloidal gold and immunochromatographic double-antibody sandwich assay. Results Of the 2 039 stool specimens,621 (30. 5% ) were found positive for cluster A RV. The positively detected patients consisted of 430 males (69.2%) and 191 females (30.8% ) ,of whom 571 cases (91.9%) aged from 6 months to 2 years. The cluster A RV was mostly detected during October to December with the positive rate of above 30% ,in which the peak (43.4%) was at November. According to the statistical data of the 18 districts of Beijing ,the cluster A RV antigen positive rates were lower to some extent in the districts near to the downtown area than in the remote counties. A few of cluster A RV positive patients were also found bacterial intestinal infection. Conclusion Cluster A RV is the major pathogen for the acute diarrhea children under 2 years of age in Beijing. And the infants aged from 6 months to 2 years ate the susceptible population for the virus. In addition,October to December epidemics is observed in Beijing. To examine the cluster A RV antigen routinely for the patients with bacterial intestinal infection in the epidemic seasons will contribute to avoiding missed diagnosis and to giving more reasonable treatments.