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目的分析武威市5岁以下儿童轮状病毒和诺如病毒腹泻的流行病学特征。方法收集武威市两所哨点医院2012-2014年门诊腹泻患儿粪便标本,采用酶联免疫吸附实验(ELISA)法检测轮状病毒(RV)抗原,检出的阳性标本用逆转录-聚合酶链反应(RT-PCR)进行G/P基因分型;采用RT-PCR检测诺如病毒(NoV),分析流行病学特征。结果共采集182份粪便标本,A组RV抗原阳性率为29.12%,男女性别差异有统计学意义(χ~2=182.000,P<0.001);2岁以下儿童为RV高发人群,高发与低发年龄段RV阳性率差异有统计学意义(χ~2=219.576,P<0.001);发病高峰出现在5月、11月,5月份阳性率最高,高发与低发月份阳性率差异有统计学意义(χ~2=279.000,P<0.001)。RV G、P分型,以G9、G3、P[8]型为主要流行株,G、P型组合模式分析显示:最常见的是G9+P[8],其次是G3+P[8]。NoV抗原阳性率为15.93%,病例年龄均为2岁以下儿童;发病也呈现两个高峰,分别为4月最高峰和12月次高峰,高发与低发月份阳性率差异具有统计学意义(χ~2=159.641,P<0.001);对NoV阳性标本进行分型,GI型占55.17%,GII型占44.83%。A组RV和NoV混合感染阳性率为6.04%。结论 RV和NoV是武威市5岁以下儿童腹泻的主要病原体,应根据流行特征做好预防工作。
Objective To analyze the epidemiological features of rotavirus and norovirus in children under 5 years old in Wuwei city. Methods Stool specimens of children with diarrhea in outpatient department during 2012-2014 were collected from two sentinel hospitals in Wuwei City. The rotavirus (RV) antigen was detected by enzyme linked immunosorbent assay (ELISA). The positive samples were detected by reverse transcription polymerase G / P genotyping by chain reaction (RT-PCR); Norovirus (NoV) by RT-PCR, analysis of epidemiological characteristics. Results A total of 182 stool specimens were collected. The positive rate of RV antigen in group A was 29.12%, there was significant difference between male and female (χ ~ 2 = 182.000, P <0.001). Children under 2 years old were high incidence of RV, The positive rate of RV in the age group was statistically significant (χ ~ 2 = 219.576, P <0.001). The peak incidence appeared in May, the positive rate was the highest in November and May, and the difference was statistically significant between the high incidence and low incidence (χ ~ 2 = 279.000, P <0.001). RVG and P genotypes. G9, G3 and P [8] strains were the main epidemic strains. The combination of G and P type patterns showed that the most common was G9 + P [8], followed by G3 + P [8] . The positive rate of NoV antigen was 15.93%, and the cases were all children under 2 years of age. The incidence also showed two peaks, the highest peak in April and the second peak in December respectively. The positive rate of NoV in the high and low incidence months was statistically significant (χ ~ 2 = 159.641, P <0.001). NoV positive specimens were typed with GI type accounting for 55.17% and GII type accounting for 44.83%. The positive rate of mixed infection of RV and NoV in group A was 6.04%. Conclusion RV and NoV are the main pathogens of diarrhea in children under 5 years of age in Wuwei City. Prevention should be based on the epidemic characteristics.