轮状病毒肠炎124例患儿肠道分泌型免疫球蛋白水平变化

目的 探讨轮状病毒(RV)性肠炎患儿肠道分泌型免疫球蛋白(SIgA)的分泌情况。方法 通过放射免疫分析法检测2002年7月~2003年7月124例RV肠炎患儿粪便中SIgA含量。采用SPSS 8.0统计软件比较观察组与对照组均值。结果 各病程日粪便标本SIgA含量均较对照组增高,肠炎d1、2、3、5 SIgA含量与对照组无显著性差异(P>0.05)。d4、6、7 SIgA含量较对照组显著性增高(P<0.01)。结论 RV肠炎患儿肠道排出SIgA增加,肠道局部免疫水平在d4达保护水平,d5出现顿挫,随后d6、7持续升高。     

抗轮状病毒牛初乳治疗轮状病毒性肠炎的初步研究

为了给临床提供特异有效的治疗婴幼儿轮状病毒感染的生物制剂，以ＳＡ１１轮状病毒免疫受孕乳牛，制备抗轮状病毒免疫牛初乳，从临床治疗角度，对８０例婴幼儿急性轮状病毒感染性腹泻，４３例应用抗轮状病毒牛初乳治疗，３７例应用思密达治疗，对两组进行了疗效对比观察。结果表明：抗轮状病毒免疫牛初乳治疗组的总有效率，显效率和７２小时粪便病毒转阴率分别达９１％，７９％和８９％；而思密达治疗组的疗效及７２小时大便病毒转阴率则相应为４１％，２４％和３９％，差异均有非常显著意义。为临床治疗婴幼儿轮状病毒感染性腹泻提供了安全有效，特异性强的治疗手段     

轮状病毒性肠炎合并肠道外感染患儿免疫功能状态研究

目的 探讨轮状病毒(rotavirus,RV)性肠炎合并肠道外感染患儿细胞及体液免疫功能状态.方法 应用流式细胞仪对30例轮状病毒性肠炎合并肠道外感染患儿(观察组)进行外周血淋巴细胞亚群检测,同时检测免疫球蛋白Iga、IgG、IgM,并与同期30例正常婴幼儿进行对照.结果 与对照组相比,观察组患儿急性期CD4 明显降低,差异有统计学意义(P＜0.05),CD8 高于对照组(P＜0.05),CD3 差异无统计学意义(P＞0.05),CD4 /CD8 比值明显低于对照组(P＜0.05);IgA、IgM水平低于对照组,差异有统计学意义(P均＜0.05).IgG两组比较差异无统计学意义(P＞0.05).结论 免疫功能紊乱与RV多系统播散可能存在一定关系.     

抗轮状病毒免疫球蛋白对轮状病毒肠炎疗效的研究

目的　观察抗轮状病毒免疫球蛋白 (Anti RVIgY即Igr或IgG)治疗轮状病毒肠炎的疗效。方法　应用ELISA方法诊断急性轮状病毒肠炎 2 14例 ,随机分为A组 (72例 )、B组 (5 6例 )及C组(86例 ) ,分别给予口服Anti RVIgY、Anti RVIgY +思密达、常规药物 (思密达 )治疗。 结果　A组及B组 3d总治愈率分别为 37 5 %、4 1 1% ,与C组 (16 3% )比较 ,有显著性差异 (P <0 0 1) ,A组及B组总有效率分别为 77 8%、80 4 % ,两组疗效比较无显著性差异 ,但与C组 (5 0 0 % )比较 ,有显著性差异 (P<0 0 1)。结论　 (1)Anti RVIgY治疗轮状病毒肠炎效果显著 ,服用方便 ,治疗中未发现毒副反应 ;(2 )思密达与Anti RVIgY合用 ,对其疗效无明显影响 ,值得临床推广应用     

婴幼儿轮状病毒性肠炎140例发病特点分析

目的 了解2002—2003年肠道门诊轮状病毒性肠炎的发病特点。方法 对2002年1月～2003年12月在肠道门诊就诊的急性腹泻患儿粪便标本进行常规检查、大便潜血检查、轮状病毒检测和细菌培养,并对1岁以下的患儿进行喂养情况的调查。结果 轮状病毒性肠炎2002年感染率为21．74％,2003年感染率为27．11％,2a总感染率为24．91％,2岁以内婴幼儿发病率高,10～12月份为发病高峰,同时合并条件致病菌生长率为23．88％;1岁以内婴儿腹泻程度母乳喂养组与人工喂养组之间比较差异有统计学意义。结论 轮状病毒仍是秋冬季婴幼儿急性腹泻的主要病原之一,母乳喂养婴儿轮状病毒肠炎腹泻的程度相对较轻;轮状病毒腹泻时存在菌群紊乱,应以调节肠道菌群和对症处理为主要治疗手段,避免滥用抗生素。     

婴幼儿轮状病毒性肠炎并心肌损害的检测

轮状病毒是婴幼儿秋季腹泻的主要病原体，其发病率和严重程度居秋冬季腹泻的首位。轮状病毒不仅可以引起肠道内感染，也能引起心肌损害，为此，笔者于2003年10月～2004年5月对我院收治的108例轮状病毒性肠炎患儿检测其心肌酶及其同工酶，并与同期53例其他病因引起的腹泻患儿进行对比分析，现报告如下。     

活菌制剂治疗婴幼儿轮状病毒性肠炎

目的　观察活菌制剂对婴幼儿轮状病毒性肠炎的疗效。方法　治疗 1组用丽珠肠乐 ,治疗 2组用小儿米雅 ,与对照组进行比较。结果　治疗 1组 72例 ,总有效率 79.2 % ,治疗 2组 6 9例 ,总有效率 78.3% ,对照组总有效率 5 7.1% ,治疗 1组和治疗 2组的显效率和总有效率均明显优于对照组 ,分别为P <0 .0 5和P <0 .0 1。结论　活菌制剂丽珠肠乐和小儿米雅在治疗婴幼儿轮状病毒性肠炎中确有疗效 ,而且在治疗中无毒副作用。     

Ultrasonography findings and symptoms in acute rotavirus gastroenteritis

Background: The aim of the present study was to better understand how clinical events in acute rotavirus gastroenteritis are depicted on ultrasonography. Methods: The relationship between abdominal ultrasonography and clinical course and symptoms was evaluated in 92 patients with acute rotavirus gastroenteritis (51 boys, 41 girls) with an average age of 30.7 ± 24.6 months. Results: Significant correlations were observed between ultrasonography score and duration of illness after ultrasonography (P= 0.0232). It was also interesting that ultrasonography findings (score: 3.1 ± 1.0 vs 3.6 ± 1.2; P= 0.0118), clinical symptoms (3.1 ± 1.7 score vs 3.8 ± 1.8 score, P= 0.0293), and duration of illness after ultrasonography (4.4 ± 1.4 days vs 3.8 ± 1.1 days, P= 0.0301) were significantly different between patients examined on ultrasonography <1 day after illness onset (n= 50, but duration of illness after ultrasonography followed only in 42) and those examined ≥2 days after onset (n= 42, but duration of illness after ultrasonography followed only in 35). Conclusion: The ability of abdominal ultrasonography to indicate severity of disease makes abdominal ultrasonography an important guide to therapy.     

婴幼儿轮状病毒肠炎的体液免疫功能研究

目的　探讨婴幼儿轮状病毒 (RV)肠炎体液免疫状况。方法　测定 44例婴幼儿RV肠炎大便分泌型IgA(sIgA)及血清免疫球蛋白 ,与同期 45例正常婴幼儿作对照。结果　 1.RV肠炎患儿恢复期较急性期sIgA和血清免疫球蛋白明显增加 ;重度RV肠炎患儿较轻、中度患儿sIgA明显减少 ,差异有显著性 (P均 <0 .0 1)。 2 .血清IgG在RV肠炎与对照组比较无显著差异 (P均 >0 .5) ;IgA、IgM较对照组明显减少 (P分别 <0 .0 0 5、 <0 .0 5) ;但病情轻重患儿间无差异。结论　婴幼儿RV肠炎免疫功能受到抑制 ,从而使全身和局部B细胞增殖及抗体的分泌减少 ,降低对RV感染的保护中和作用 ,提示在治疗RV肠炎时可合理应用免疫球蛋白 ,以达到减轻症状、缩短疗程的作用     

Child rotavirus infection in association with acute gastroenteritis in two Chinese sentinel hospitals

Rotavirus gastroenteritis is an important pediatric disease in China. In a survey of rotavirus infection at two sentinel hospitals in China (Beijing Friendship Hospital and Changchun Children's Hospital), 296 cases were detected. A total of 283 (95.6%) cases of rotavirus infection occurred in children under 5 years of age. Serotype G1 (62%) was most prevalent followed by G2 (28.5%), G3 (5%) and G4 (2%). Mixed infections (n = 8, 3%) were rate, and 16 isolates (5.5%) remained non-typeable. A consistent epidemic occurred during the winter. Rotavirus was responsible for about 61.8% of diarrhea-related hospitalizations in children under 5 years of age, with a mean hospital stay of 5.6 days (1.0-21 days). The estimated rate of rotavirus-attributed hospitalizations was 16/1000 children under 5 years of age per year. Rotavirus-related death is rare in Changchun and Beijing. The present findings suggest that a rotavirus vaccine for the prevention of severe disease and a reduction of treatment costs would be of significant benefit to China.     

Molecular epidemiology of viral gastroenteritis in Asia

Acute gastroenteritis is one of the most common diseases in humans, and continues to be a significant cause of mortality and morbidity worldwide. Recently the estimates of mortality associated with diarrhea declined, however the majority of deaths still occur in developing countries and thus urgent intervention is needed for the prevention of these diseases. In Asian countries it is very important to study the distribution, transmission and characteristics of prevalent viruses in order to produce viral vaccines. The viruses which cause gastroenteritis are primarily from four distinct families - group A rotaviruses, caliciviruses, enteric adenoviruses and astroviruses. Rotavirus is a common virus that causes severe gastroenteritis in children <5 years of age. The reassortant viruses with animal virus, or directly animal viruses are isolated in humans. The future development of a safe and effective vaccine against rotavirus, along with the expansion of understanding of the distribution of types in Asia and an availability of rapid diagnostic tests, could reduce mortality and might be able to prevent severe gastroenteritis. Calicivirus is a causative virus of acute gastroenteritis in children and has been known to contaminate food causing viral outbreaks affecting people of all ages. Recently, the understanding of calicivirus and the improvement of detection techniques has increased the total frequencies of diarrheal viruses. For the future control and prevention of diarrheal diseases it is necessary to examine the molecular epidemiology of caliciviruses as well as rotaviruses.     

Opsoclonus–myoclonus syndrome following rotavirus gastroenteritis

Opsoclonus–myoclonus syndrome (OMS) is a rare neurologic disorder characterized by opsoclonus, myoclonus, ataxia and behavioral disturbance. In the pathogenesis, an autoimmune process with infectious or paraneoplastic trigger has been suggested. We describe the case of a 22‐month‐old girl with OMS following rotavirus gastroenteritis. Rotavirus should be considered in the differential diagnosis of OMS in children.     

Prospective population-based study on rotavirus disease in Germany

The aim of this study was to collect representative data on the incidence and clinical characteristics of community-acquired acute gastroenteritis (AGE) due to rotavirus (RV) in German children up to 4 y of age. In 20 paediatric practices in 5 German regions every child aged 0-4 y presenting with symptoms of AGE from May 1997 to April 1998 was eligible for inclusion into the study. Stool samples were tested for RV antigen by enzyme-linked immunosorbent assay and polymerase chain reaction was performed for serotyping. The course of the disease, additional diagnoses and treatment regimen were recorded. Incidences adjusted for month and region of observation were calculated by Poisson regression. Of 15,451 children under observation 3980 (26%) presented with AGE. Of 3156 stool samples available 748 (24%) proved RV positive. The incidence of AGE and RV-positive AGE was 25.2 and 4.0 per 100 children per year, respectively, with a maximum in February/March 1998. RV-positive cases were more severe than RV-negative cases (28% vs 12% severe cases, hospitalization rate 6.2% vs 2.0%, p < 0.001). The predominant genotype of RV isolated was G1/P[8] (77%), followed by G4/P[8] (17%). CONCLUSION: Rotavirus accounts for a substantial part of severe cases of AGE in children up to 4 y of age. Efficient prevention, including immunization against the circulating serotypes, could save at least 122,000 children in Germany from falling ill with RV-AGE each year.     

Prostaglandins in the plasma and stool of children with rotavirus gastroenteritis

To investigate whether prostaglandins (PGs) are involved in the mechanism of rotavirus diarrhea, PGE2 and PGF2 alpha concentrations in the plasma and stool of children (21 and 16, respectively) with rotavirus gastroenteritis were measured and compared with those of their respective controls. The effect of aspirin on the diarrhea was also studied in 14 patients with rotavirus gastroenteritis. The PGE2 and PGF2 alpha contents of both the plasma and the stool of patients with rotavirus gastroenteritis were significantly higher than in the plasma and stool of the control group. Furthermore, aspirin given by mouth caused the diarrhea to cease earlier. These results suggest that PGE2 and PGF2 alpha are involved as important mediators in the causative mechanism of rotavirus diarrhea.