2011—2015年北京西城区成人门诊腹泻患者诺如病毒与轮状病毒感染的流行病学特征

目的了解门诊腹泻病例中诺如病毒和轮状病毒感染现状,分析本辖区病毒感染性腹泻的流行特征。方法以2011—2015年在北京市西城区两所三甲医院成人肠道门诊就诊的腹泻病例作为监测对象,对其进行诺如病毒和轮状病毒检测及流行病学调查分析。结果调查检测腹泻病例共714例,200例检测阳性,总阳性率28.01%;其中轮状病毒检测阳性率为10.08%;诺如病毒检测阳性率为18.63%。诺如病毒检测阳性率显著高于轮状病毒阳性率(χ~2=7.211,P<0.05)。诺如病毒检测阳性病例中有腹泻10次以上、恶心、呕吐、水样便症状的病例百分比明显高于检测阴性病例;轮状病毒检测阳性病例中有腹痛症状的病例百分比明显低于检测阴性病例,腹泻10次以上的病例百分比明显高于检测阴性病例;诺如病毒及轮状病毒检测阳性病例中,便常规检查分别有白细胞和红细胞的病例百分比均显著低于检测阴性病例,差异有统计学意义。结论北京市西城区成人肠道门诊就诊的腹泻患者中诺如病毒和轮状病毒感染较为普遍,腹泻多次水样便、恶心、呕吐是诺如病毒感染的常见症状;次数较多的无腹痛腹泻是轮状病毒感染的常见表现。

Analysis of clinical and epidemiological features of Rotavirus and Norovirus infe4ction in adults with acute gastroenteritis in Xicheng District,Beijng (2011-2015)

Objective To investigate the epidemiologic and clinical characteristics of Norovirus (NV) and Rotavirus (RV) among the adult patients with acute gastroenteritis in Xuanwu District of Beijing.Methods Epidemiologic data and fecal specimens were collected from patients with acute gastroenteritis in 2 hospitals from 2011 to 2015.ELISA and PCR were used to detect RV and NV infection,and epidemic characteristics of the cases was analyzed.Results 200 virus positive cases were identified from 714 fecal specimens (28.01％).The prevalence rate of NV (18.63 ％) was higher than RV (10.08 ％) (x2 =7.211,P ＜ 0.05).Watery stool,nausea and vomiting were more prevalent in NV-positive patients than in negative patients (P ＜ 0.05).Bellyache were less prevalent in NV-positive patients than in negative patients (P ＜ 0.05).Among the NV-positive and RV-positive cases,the proportion of RBC-positive and WBC-positive was obvious lower than that of the negative cases,and of statistical significance.Conclusion In adult diarrheal OPD of Xicheng District,Beijing NV-and RV infection were quite popular,most symptoms were watery stool,nausea,vomiting.The common features of RV-infection were frequent diarrhea without bellyache.It is necessary to strengthen the etiology monitoring of the acute gastroenteritis,so that we can take comprehensive measures before the peak of the viral diarrhea occurs.