目的:比较儿童胃肠型流感及有发热症状的轮状病毒性肠炎临床特征,以提高临床诊断水平。方法:回顾性分析2017年12月至2018年1月胃肠型流感及轮状病毒性肠炎患儿的临床资料。结果:1) 胃肠型流感102例,轮状病毒性肠炎268例,胃肠型流感组发病年龄均数为3.9 ± 2.3岁,轮状病毒性肠炎组发病年龄均数为1.9 ± 1.8岁,组间差异存在统计学意义(t = 8.2, P < 0.01),两组间性别构成比差异无统计学意义(P > 0.05);2) 全部病例均有发热,以热峰超过39℃界定为高热,胃肠型流感高热发生率为88.2% (90/102),轮状病毒性肠炎组74.6% (200/268),组间差异存在统计学意义(X2 = 8.1, P < 0.01);胃肠型流感组热峰为39.2 ± 0.7℃,轮状病毒性肠炎组38.8 ± 0.6℃,组间差异存在统计学意义(t = 6.1, P < 0.01);3) 全部病例均有不同程度腹泻和(或)呕吐,每日腹泻最多次数轮状病毒性肠炎组为5.4 ± 2.9次,高于胃肠型流感组1.3 ± 1.9次,组间差异存在统计学意义(t = ?16.0, P < 0.01);每日呕吐最多次数轮状病毒性肠炎组为2.7 ± 2.7次,高于胃肠型流感组1.8 ± 1.8次/天,组间差异存在统计学意义(t = ?4.1, P < 0.01);4) 以Vesikari临床严重度评分系统评判严重程度,胃肠型流感组5.9 ± 1.6分,轮状病毒性肠炎组8.3 ± 2.4分,组间差异存在统计学意义(t = 11.2, P < 0.01),两组轻中重度例数占比比较差异存在统计学差异(X2 = 86.2, P < 0.01)。结论:胃肠型流感与轮状病毒性肠炎在发病季节上有交叉,临床特征类似,但发热热峰、腹泻及呕吐频次、疾病严重程度有所不同,快速病原学检测有助于鉴别诊断。
Objective: To compare the clinical features of gastrointestinal influenza and rotavirus enteritis with fever in children. Methods: Clinical data of children with gastrointestinal influenza and rotavirus enteritis from December 2017 to January 2018 were retrospectively analyzed. Results: 1) There were 102 cases of gastrointestinal influenza and 268 cases of rotavirus enteritis. The mean age of onset of gastrointestinal influenza was 3.9 ± 2.3 years, and the group of rotavirus enteritis was 1.9 ± 1.8 years. The difference between the two groups was statistically significant (t = 8.2, P < 0.01). There was no statistically significant difference in gender composition between the two groups (P > 0.05). 2) All patients had a fever. It is defined as high heat when the thermal peak exceeds 39℃. The high fever incidence of gastrointestinal influenza was 88.2% (90/102), and the group of rotavirus enteritis was 74.6% (200/268). The difference between the two groups was statistically significant (X2 = 8.1, P < 0.01). The heat peak of gastrointestinal influenza group was 39.2 ± 0.7℃, while that of rotavirus enteritis group was 38.8 ± 0.6℃. There was significant difference between the two groups (t = 6.1, P < 0.01). 3) All the patients had diarrhea and vomiting of varying degrees. The maximum number of diarrhea per day in the group of rotavirus enteritis was (5.4 ± 2.9) times, which was higher than that in gastrointestinal influenza group (1.3 ± 1.9) times, there was statistical significance between the two groups (t = ?16.0, P < 0.01). The maximum number of vomiting per day in rotavirus enteritis group was (2.7 ± 2.7) times, which was higher than that in gastrointestinal
Lewis, K.D.C., Dallas, M.J., Victor, J.C., et al. (2012) Comparison of Two Clinical Severity Scoring Systems in Two Multi-Center, Developing Country Rotavirus Vaccine Trials in Africa and Asia. Vaccine, 30, A159-A166.
https://doi.org/10.1016/j.vaccine.2011.07.126