【摘要】 目的 了解河北省卢龙县5岁以下儿童病毒性腹泻的病原组成及变化趋势,为婴幼儿病毒性腹泻防治提供科学依据。方法 收集卢龙县某医院和某妇幼保健院2016年1月1日—2021年12月31日共832份5岁以下住院患儿粪便标本,并填写流行病学个案调查表。轮状病毒（Rotavirus, RV）抗原及其阳性标本G/P进一步分型检测分别用酶联免疫吸附试验（enzyme linked immunosorbent assay, ELISA）和逆转录聚合酶链式反应（reverse transcription PCR,RT-PCR）。人类杯状病毒（Human calicivirus, HuC V）、肠道腺病毒（Enteric adenovirus, EAdV）、星状病毒（Astrovirus,AstV）用RT-PCR或实时荧光定量PCR方法检测,诺如病毒（Norovirus, NV）阳性样本经RT-PCR扩增后测序分型。结果 832份标本共检出4种病毒576份,总阳性检出率为69.23%, RV、 HuC V、 EAdV和AstV检出率分别为38.22%、 31.01%、 6.01%和5.17%,单一病原体感染检出率为58.41%,混合感染检出率为10.82%,其中2种病毒合并感染的样本87份, 3种病毒合并感染的样本3份。不同性别间各病毒及混合感染阳性检出率差异无统计学意义(χ_RV²=0.811,P_RV=0.368;χ_HuCV²=0.286,P_HuCV=0.593;χ_EAdV²=0.156,P_EAdV=0.693;χ_AstV²=0.035,P_AstV=0.852;χ_混合感染²=0.617,P_混合感染=0.432)。RV和HuC V以18～<24月龄阳性检出率最高(χ_RV²=18.748,P_RV=0.009;χ_HuCV²=2.797,P_HuCV=0.903),分别为47.69%和33.85%。病毒性腹泻在1～3月和11、 12月为高发季, RV在2月阳性检出率最高（59.51%）, HuC V在11月阳性检出率最高（62.90%）, HuC V和EAdV性腹泻全年均有发病。RV中G9P[8]型占90.25%, HuC V中GⅡ型占67.05%。结论 卢龙县5岁以下婴幼儿病毒性腹泻病原以RV和HuC V为主,HuC V阳性检出率增幅较大。RV以G9P[8]型、 HuC V以GⅡ型为主要流行株。更多还原

【Abstract】 Objective To understand the pathogen composition and changing trend of viral diarrhea in children under 5 years old in Lulong County,Hebei Province,so as to provide scientific basis for the prevention and treatment of viral diarrhea in infants and young children.Methods A total of 832 stool samples of children under 5 years old were collected from a Lulong County hospital and maternal and child health hospital from January 1,2016 to December 31,2021,and the epidemiological case study form was filled in. Rotavirus（ RV） antigen and its positive G/P samples were further typing by enzyme linked immunosorbent assay（ELISA） and reverse transcription PCR（RT-PCR）,respectively. Human calicivirus（Hu CV）,enteric Adenovirus（EAd V） and Astrovirus（Ast V） were detected by RT-PCR or real-time quantitative PCR. Norovirus（NV） positive samples were amplified by RT-PCR and then sequenced and typed.Results A total of 576 of 832 samples were positive for four kinds of viruses,and the total positive detection rate was 69. 23%. The positive detection rates of RV,Hu CV,EAd V and Ast V were 38. 22%,31. 01%,6. 01% and 5. 17%,respectively. Single pathogen infection detection rate was 58. 41%,and mixed infection detection rate was 10. 82%,of which 87 samples were co-infected with two viruses and 3 samples were co-infected with three viruses. There was no statistically significant difference in the positive detection rates of viruses and mixed infections between different genders(χ_RV²= 0. 811,P-（RV）= 0. 368; χ_HuCV⁼ 0. 286,P_HuCV= 0. 593;χ_EAdV²= 0. 156,P_EAdV= 0. 693;χ_AstV²= 0. 035,P_AstV= 0. 852;χ_{mixed infection}²= 0. 617,P_{mixed infection}= 0. 432). RV and Hu CV had the highest positive detection rates of 47. 69% and 33. 85% at the age of 18 to less than 24 months(χ_RV²= 18. 748,P_RV= 0. 009;χ_HuCV²= 2. 797,P_HuCV= 0. 903),respectively. The peak seasons of viral diarrhea were January to March,November and December. RV had the highest positive detection rate in February（59. 51%）,and Hu CV had the highest positive detection rate in November（62. 90%）. HuCV and EAdV diarrhea occurred all year round. The proportion of type G9P[8] in RV was 90. 25%,and the proportion of type GII in Hu CV was 67. 05%.Conclusion RV and Hu CV are the main pathogens of viral diarrhea in infants and young children under 5 years old in Lulong County,and the positive detection rate of HuCV increased greatly. RV type G9P[8] and HuCV type GⅡ are the main epidemic strains.更多还原