诺如病毒感染性腹泻肠道排毒时间及其影响因素

张蔚; 古子豪; 满云翔; 陈宏标; 黄晓云; 贺深莉

doi:10.16462/j.cnki.zhjbkz.2022.12.018

诺如病毒感染性腹泻肠道排毒时间及其影响因素

doi: 10.16462/j.cnki.zhjbkz.2022.12.018

518109 深圳，深圳市龙华区疾病预防控制中心

基金项目:

深圳市龙华区医疗卫生机构2021年区级科研项目 2021108

详细信息

通讯作者:
张蔚，E-mail: 346810994@qq.com

中图分类号: R183.4
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- 被引次数: 0
出版历程
- 收稿日期: 2021-10-15
- 修回日期: 2022-02-24
- 网络出版日期: 2022-12-30
- 刊出日期: 2022-12-10

Analysis of intestinal detoxication time and its influencing factors in norovirus infectious diarrhea

Department of Epidemiology and Infectious Disease Control, Longhua Centre for Disease Control and Prevention, Shenzhen 518109, China

Funds:

2021 District Level Scientific Research Projects of Medical and Health Institutions in Longhua District Shenzhen 2021108

More Information

Corresponding author: ZHANG Wei, E-mail: 346810994@qq.com

摘要

摘要: 目的研究诺如病毒肠道排毒规律，找出影响其肠道排毒时间的因素。方法采集深圳市龙华区3起发生诺如病毒感染性腹泻暴发疫情中涉疫人群的肛拭子标本并检测，定期监测并计算排毒期，分析临床症状和基本特征等排毒期的影响。结果共监测3起聚集性疫情涉及255名对象，型别均为GII型，纳入研究对象91名。采取停课措施后(疫情发生后3~5 d)，病毒感染率达到最高值，幼儿较成人的排毒时间更长(HR=0.235，P＜0.001)，不同岗位人群排毒期比较差异有统计学意义(H=8.528，P=0.014)。学生病例中未发热感染者较发热病例(HR=2.281，P=0.025)排毒期更长。结论诺如病毒隐性感染者和病例在班级复课后仍持续带毒，二者排毒期无差异，但学生群体中隐性感染者较病例排毒期更长，易造成疫情二次传播风险。
- 诺如病毒 /
- 排毒期 /
- 腹泻
Abstract: Objective To study the regularity of norovirus intestinal detoxification and to find out the factors affecting norovirus intestinal detoxification time. Methods To collect and test the anal swabs of the people involved in three outbreaks of norovirus infectious diarrhea in Longhua district of Shenzhen City, and regularly monitor and calculate the detoxification period, to analyze the influence of detoxication period on clinical symptoms and basic characteristics. Results A total of 255 subjects, all of which were GII type, were monitored in 3 clusters of 91 subjects. After the suspension of classes (3-5 days after the outbreak), the virus infection rate reached its highest level, the detoxication time of infants was longer than that of adults (HR=0.235, P < 0.001), and the detoxication time of different groups was significantly different (H=8.528, P=0.014). The detoxication period of non-febrile patients was longer than that of febrile patients (HR=2.281, P=0.025). Conclusions There was no difference in the detoxification period between the patients with latent norovirus infection and the patients with latent norovirus infection, but the patients with latent norovirus infection had a longer detoxification period than the patients with latent norovirus infection.
- Norovirus /
- Detoxication period /
- Diarrhea

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图 1 阳性率检测变化

Figure 1. Change of positive rate detection

下载: 全尺寸图片幻灯片

图 2 身份类型的累计生存函数图

Figure 2. Cumulative survival function diagram for identity types

下载: 全尺寸图片幻灯片

表 1 变量赋值一览表

Table 1. Summary of variable assignments

变量	赋值
学校	学校1=1；学校2=2；学校3=3
身份类型	学生=1；教师=2；后勤=3
性别	男=1；女=1
年龄	3~6岁=1；20~30岁=2；＞30岁=3
是否就诊	就诊=1，未就诊=2
症状	有发热=1，无发热=2；有呕吐=1，无呕吐=2；有腹泻=1，无腹泻=2；有腹痛=1，无腹痛=2

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表 2 排毒期的影响因素Cox回归分析

Table 2. Cox regression analysis of influencing factors during detox period

变量	β值	s_x值	Wald值	P值	Exp(B)	95% CI值
变量	β值	s_x值	Wald值	P值	Exp(B)	下限	上限
学校1	-1.263	0.383	10.880	0.001	0.283	0.134	0.599
学校2	-0.948	0.150	9.049	0.003	0.387	0.209	0.719
身份类型1	-1.450	0.326	19.754	＜0.001	0.235	0.124	0.445

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表 3 学生排毒期的影响因素Cox回归分析

Table 3. Cox regression analysis of influencing factors on detoxification period of students

变量	β值	s_x值	Wald值	P值	Exp(B)	95% CI值
变量	β值	s_x值	Wald值	P值	Exp(B)	下限	上限
学校1	-1.248	0.432	8.361	0.004	0.287	0.123	0.669
学校2	-1.201	0.376	10.185	0.001	0.301	0.144	0.629
发热	0.825	0.368	5.012	0.025	2.281	1.108	4.695

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