中国内地住院患儿病毒性胃肠炎流行病学和临床特征的变化：一项回顾性研究（2016 年至 2020 年）。
Changes in the epidemiology and clinical characteristics of viral gastroenteritis among hospitalized children in the Mainland of China: a retrospective study from 2016 to 2020.
机构信息
Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, Laboratory of Infection and Virology, Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Department of Infectious Disease, National Center for Children's Health, Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing Children's Hospital, Capital Medical University, Beijing, China.
出版信息
BMC Pediatr. 2024 May 4;24(1):303. doi: 10.1186/s12887-024-04776-1.
BACKGROUND
Acute gastroenteritis (AGE) causes significant morbidity in children worldwide; however, the disease burden of children hospitalized with viral gastroenteritis in China has been rarely described. Through this study, we analyzed the data of hospitalized children with viral gastroenteritis to explore the changes in the epidemiology and clinical characteristics of viral gastroenteritis in the mainland of China.
METHODS
Data were extracted from Futang Children's Medical Development Research Center (FRCPD), between 2016 and 2020, across 27 hospitals in 7 regions. The demographics, geographic distribution, pathogenic examination results, complications, hospital admission date, length of hospital stays, hospitalization charges and outcomes were collected and analyzed.
RESULTS
Viral etiological agents included rotavirus (RV), adenovirus (ADV), norovirus (NV) and coxsackievirus (CV) that were detected in 25,274 (89.6%), 1,047 (3.7%), 441 (1.5%) and 83 (0.3%) cases. There was a higher prevalence of RV and NV infection among children younger than 3 years of age. RV and NV had the highest detection rates in winter, while ADV in summer. Children with viral gastroenteritis were often accompanied by other diseases, such as myocardial diseases (10.98-31.04%), upper respiratory tract diseases (1.20-20.15%), and seizures (2.41-14.51%). Among those cases, the co-infection rate with other pathogens was 6.28%, with Mycoplasma pneumoniae (M. pneumoniae), Epstein-Barr virus (EBV), and influenza virus (FLU) being the most common pathogens. The median length of stay was 5 days, and the median cost of hospitalization corresponded to587 US dollars.
CONCLUSIONS
This finding suggests that viral gastroenteritis, especially those caused by RV, is a prevalent illness among younger children. Co-infections and the presence of other diseases are common. The seasonality and regional variation of viral etiological agents highlight the need for targeted prevention and control measures. Although viral gastroenteritis rarely leads to death, it also results in a significant economic burden on healthcare systems.
背景
急性肠胃炎（AGE）在全球范围内给儿童带来了较大的发病负担；然而，中国儿童因病毒性肠胃炎住院的疾病负担鲜有报道。通过本研究，我们分析了因病毒性肠胃炎住院的儿童数据，以探讨中国大陆地区病毒性肠胃炎的流行病学和临床特征变化。
方法
本研究数据来自于傅棠儿童医学发展研究中心（FRCPD），时间跨度为 2016 年至 2020 年，涵盖了全国 7 个地区 27 家医院。我们收集并分析了人口统计学特征、地理分布、病原学检查结果、并发症、住院日期、住院时间、住院费用和结局等数据。
结果
在 25274 例（89.6%）、1047 例（3.7%）、441 例（1.5%）和 83 例（0.3%）患儿中，分别检测到轮状病毒（RV）、腺病毒（ADV）、诺如病毒（NV）和柯萨奇病毒（CV）。3 岁以下儿童 RV 和 NV 感染率较高，RV 和 NV 在冬季检出率较高，ADV 在夏季检出率较高。病毒性肠胃炎患儿常伴有其他疾病，如心肌疾病（10.98%-31.04%）、上呼吸道疾病（1.20%-20.15%）和癫痫发作（2.41%-14.51%）。其中，合并其他病原体感染率为 6.28%，最常见的病原体为肺炎支原体（M. pneumoniae）、EB 病毒（EBV）和流感病毒（FLU）。中位住院时间为 5 天，中位住院费用为 587 美元。
结论
本研究表明，病毒性肠胃炎，尤其是 RV 引起的肠胃炎，是婴幼儿常见的疾病。合并感染和其他疾病的存在较为常见。病毒病原体的季节性和区域性变化表明需要采取有针对性的预防和控制措施。尽管病毒性肠胃炎很少导致死亡，但它也给医疗系统带来了巨大的经济负担。
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