儿童胃肠型流感与轮状病毒性肠炎的临床特征比较

Comparison of Clinical Features between Gastrointestinal Influenza and Rotavirus Enteritis in Children

摘要: 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。

Abstract: 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 influenza group (1.8 ± 1.8) times. There was statistical significance between the two groups (t = −4.1, P < 0.01). 4) The severity was evaluated by Vesikari clinical severity scoring system. Gastrointestinal influenza group scores 5.9 ± 1.6 points and rotavirus enteritis group scores 8.3 ± 2.4 points. There was significant difference between the two groups (t = 11.2, P < 0.01). There was statistical difference in the proportion of light, moderate and severe cases between the two groups (X² = 86.2, P < 0.01). Conclusion: Gastrointestinal influenza and rotavirus enteritis are intersected in season, the clinical characteristics are similar, but the frequency of heat peak, diarrhea and vomiting, and disease severity is different. Rapid etiological detection is helpful for differential diagnosis.