儿童病毒性胃肠炎主要病原谱演变及临床研究进展

Evolution of the Primary Pathogen Spectrum and Clinical Research Progress in Viral Gastroenteritis in Children

摘要: 病毒性胃肠炎(viral gastroenteritis, VGE)是儿童急性胃肠炎最常见的病因之一，也是导致5岁以下儿童腹泻相关发病和住院的重要原因。近年来，随着轮状病毒疫苗的推广应用、分子诊断技术的发展以及病原监测体系的完善，儿童病毒性胃肠炎的病原谱和流行特征发生明显变化。轮状病毒(rotavirus, RV)、诺如病毒(norovirus, NV)和肠道腺病毒(adenovirus, AdV)仍为主要致病病原，但不同病原在流行优势、临床表现及疾病负担方面存在显著差异。本文结合近年来国内外研究进展，对上述主要病毒的流行病学特点、致病机制、临床表现、实验室诊断及疫苗研发进展进行综述，并重点分析疫苗时代背景下儿童病毒性胃肠炎病原谱变化趋势及防控面临的新挑战，以期为儿童病毒性胃肠炎的精准诊疗和综合防控提供参考。

Abstract: Viral gastroenteritis (VGE) is one of the most common causes of acute gastroenteritis in children and a major cause of diarrhea-related morbidity and hospitalization among children under 5 years of age. In recent years, with the widespread use of rotavirus vaccines, advances in molecular diagnostic technologies, and improvements in pathogen surveillance systems, the pathogen spectrum and epidemiological characteristics of viral gastroenteritis in children have undergone significant changes. Rotavirus (RV), norovirus (NV), and enteric adenovirus (AdV) remain the primary causative pathogens, but there are significant differences among these pathogens in terms of epidemiological dominance, clinical manifestations, and disease burden. This article reviews the epidemiological characteristics, pathogenic mechanisms, clinical manifestations, laboratory diagnosis, and vaccine development progress of these major viruses, drawing on recent domestic and international research advancements. It focuses on analyzing trends in the pathogen spectrum of viral gastroenteritis in children and the new challenges facing prevention and control in the era of vaccines, with the aim of providing guidance for the precise diagnosis, treatment, and comprehensive prevention and control of viral gastroenteritis in children.