6个月以内婴儿急性腹泻病原学及有关发病因素分析

目的研究6个月以内婴儿腹泻病的病因及病原流行病学特点。方法选择2002年1月至2003年12月在我院感染消化科就诊的6个月以下婴儿腹泻患儿192例，对其粪便标本采用酶联免疫吸附试验（ELISA）检测诺如病毒抗原，用聚丙烯酰胺凝胶电泳（PAGE）检测轮状病毒并对粪便标本进行细菌培养。抽取58例患儿血清用荧光分光光度计检测维生素A含量，通过问卷调查获得喂养方式。结果192份标本中检测出诺如病毒17例，占8．8％：轮状病毒48例，占25％；病原菌42株，占21．9％。纯母乳喂养32例，占16．7％；人工与混合喂养160例．占83.3％。58例腹泻患儿中43例（74．1％）维生素A缺乏[维生素A≤（0．70±0．40）μmol／L]。结论6个月以下婴儿腹泻的主要病原为病毒及条件致病菌。母乳喂养可减少腹泻的发病率。维生素A缺乏亦可为感染性腹泻病的发病因素之一．

The etiology and pathogenesis of acute diarrhea in the infant under six months

Objective To investigate the pathology of diarrhea in the infant under six months and to figure out its epidemiology characteristics. Methods 192 excrement samples of the infant patient under six month had been collected from department of infection and digestion of the children＇ s hospital attached to Capital Paediatric Insititute from January, 2002 to December, 2003. ELISA was applied to detect the antigen of Norovirus and PAGE was used to detect Rotavirus Bacteria cultivation of the excrement samples was performed. Serum samples of 58 infant patients were examined by fluorospectrophotometer to identify the concentration of the VitA and the feeding style was also investigated via questionnaire. The data above were analyzed. Results 17 samples of Norovirus, 48 samples of Rotavirus, 42 samples of pathogeny were found in 192 specimens, which were 8.8%, 25% and 21.9% respectively. The percentage of the 32 cases of breast feeding and 160 cases of blended feeding respectively were 16.6% and 83.3%. There were 43 patients of VitA deficiency [VitA ≤（0.70±0.40）μmol/L] out of 58 infant patients with diarrhea which accounted for74.1%. Conclusions The main pathogen of the infant patient with diarrhea disease under six month are virus and conditioned pathogen. Breast feeding could decrease the incidence of diarrhea VitA deficiency may also be one of the causes of diarrhea.