婴幼儿轮状病毒感染致胃肠外脏器损害的临床分析

目的探讨轮状病毒（rotavirus,RV）感染对胃肠外脏器损害的临床表现特点。方法新疆医科大学第五附属医院2007年1月~2009年10月收住院276例急性腹泻患儿,用酶联免疫吸附试验检测粪便RV抗体,IgM阳性腹泻患儿为观察组112例与同期其他原因所致的腹泻患儿为对照组164例,对两组病例进行回顾性分析,比较两组一般情况、肠道症状、肠外表现及实验室检查。结果两组胃肠外脏器损害发生率比较,差异有统计学意义（P=0.0271）,通过比较两组脱水、电解质紊乱、酸碱平衡紊乱的发生率（P〈0.05）,无明显差异,提示胃肠外脏器损害发生率与病情轻重无关;比较观察组不同年龄段（≤1岁和〉1岁）发生肝脏损害的发生率（P=0.013）,差异有统计学意义,提示年龄越小患儿,发生肝脏损害的几率越高;两组相应受累脏器损害的发生率一一比较,结果显示均有差异。结论RV感染引起的胃肠外脏器损伤临床上多表现为潜伏型及亚临床型,在诊治时,应重视肠外脏器有无受损情况,并给予积极有效对症治疗,一般患儿均预后良好。

Clinical Analysis of Involved Organs Besides Gastro-intestine after Rotavirus Infection in Infants and Young Children

Objective To study clinical manifestations of organ damage besides gastro-intestine after rotavirus （RV） infection in infants and young children. Methods ELISA was taken to detect feces for RV antibody of 276 children with acute diarrhea in the hospital from January 2007 to October 2009. All patients were divided into RV IgM positive group （detected group, 112 children）and negative group （control group, 164 children）. A retrospective analysis was carried out to compare general condition, intestinal symptom, manifestation outside the intestine and laboratiory examination between the two groups. Results There was statistical difference in incidence of organ damage besides gastro-intestine between the two groups （P=0.027 1） No difference was found in simultaneous phenomenon （dehydration, electrolyte disturbances, and acid base-equability derangement, P〈0.05）. It indicated that there was no relationship between the incidence and patients＇ condition. Statistical difference in incidence of hepatic damage was observed in different age stages （≤1 year-old and〉 1 year-old） in the detected group（P=0.013 0）, that suggested the lower age for rotavirus infection, the higher incidences of liver damage. Differences were detected in incidences of involved organs in two groups, respectively. Conclusions Clinical manifestations of organ damages besides gastro-intestine after RV infection are most of delitescence and sub-clinic. It should think highly of whether there are organs involved besides stomach and intestine in the diagnosis and treatment, effectively symptomatic treatment must be administered positively, so that the patients will get good prognosis.