北京地区2008年儿童轮状病毒腹泻的流行病学研究

目的：探讨北京地区2008年儿童轮状病毒（RV）腹泻的流行病学特征。方法：采集2008年1—12月来我院肠道门诊就诊的急性腹泻患儿的粪便标本，以免疫层析双抗体夹心法定性检测A群RV抗原，分析RV腹泻在性别、年龄、发病季节及地域等方面的分布特点。结果：受检患儿共9843例，检出RV感染患儿共2249例，总检出率为22．8％，男女检出率比为1．6：1。男孩检出率为22．2％（1385／6226例），女孩检出率为23．9％（864／3617例），二者之间差异无显著性（P〉0．05）。将受检患儿分为〈6个月、6个月～2岁、2～3岁和〉3岁共4组，其RV检出率分别为19．7％、25．0％、22．7％和11．3％，3岁以下各组的检出率均高于〉3岁组（P〈0．05或P〈0．01），而3岁以下各组之间的检出率差异无显著性（P〉0．05）。RV腹泻病例终年未断，检出率在3月份（37．1％）和11月份（58．8％）呈现两个高峰，最低为9月份（7．5％）。检出率较高的区域主要分布于北京西部和北部的区县。经粪培养证实RV合并肠道致病菌感染者10例，混合感染率为0．4％（10／2249例），均为6个月～2岁婴幼儿。结论：北京地区3岁以下儿童为A群RV的易感人群，其中6个月～2岁婴幼儿为RV与细菌混合感染的易感人群；2008年RV腹泻全年均有发生，在春季和秋冬季出现两个发病高峰，应根据流行病学特点适时为儿童接种RV疫苗预防RV腹泻。

Study on epidemiology of rotavirus diarrhea in children in Beijing area in 2008

Objective：To investigate the epidemiologic features of rotavirus （RV） diarrhea in children in Beijing area in 2008. Methods：Stool specimens were collected from the outpatients with acute diarrhea in the enterology clinic of Beijing Children＇s Hospital affiliated to Capital Medical University from January through December 2008. The cluster A RV antigen was detected in the stool specimens by the qualitative technique of colloidal gold and immunochromatographic double-antibody sandwich assay. The sex, age of onset, seasons and area distribution were analyzed. Results：Of the 9 843 cases, which included 6 226 males and 3 617 females, 2 249 （22.8%） were found positive for cluster A RV. The patients with positive result consisted of 1 385 males and 864 females with the ratio of 1.6 ： 1, while there was no significant difference in the detection rate of RV between males （22.2%） and females （23.9%）. The entire patients were divided into 4 age groups as 〈6 months, 6 months--2 years, 2--3 years and 〉3 years, and the positive detection rate of RV was 19.7%, 25.05%, 22.7% and 11.3%, respectively. The RV detection rate in the groups under 3 years of age was higher than that of group older than 3 years of age （P〉0.05）, while there was no significant difference among the groups under 3 years of age （P〉0.05）. Cases with RV diarrhea were observed throughout the year, and it was found that there were two peaks of detection rate appearing in March （37.1%） and November （58.8%）, and it was lowest in September （7.5%）. The areas with relatively higher RV detection rates were mainly located in the western and northern suburbs and counties in Beijing. A total of 10 RV-positive patients, all of whom were aged from 6 months--2 years, were also found to have bacterial intestinal infection confirmed by the stool bacterial culture, resulting in a mixed infection rate of 0. 4% （10/2 249 cases）. Conclusion： Children under 3 years of age in Beijing area are the susceptible population for cluster A RV, among whom infants aged from 6 months to 2 years are the susceptible population for RV-baeteria coinfectious diarrhea. Cases of RV diarrhea were found throughout the year with two peaks in spring and autumn-winter in 2008. Timely vaccination for children based on the epidemiologic features is effective for reducing the incidence of RV diarrhea.