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星状病毒作为儿童肠胃炎的一个病因

Astroviruses as a cause of gastroenteritis in children.

作者信息

Herrmann J E, Taylor D N, Echeverria P, Blacklow N R

机构信息

Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester 01655.

出版信息

N Engl J Med. 1991 Jun 20;324(25):1757-60. doi: 10.1056/NEJM199106203242501.

Abstract

BACKGROUND

Infection with astroviruses has been associated with gastroenteritis in children, and serologic surveys indicate that this infection may be frequent. The importance of astroviruses as agents of gastroenteritis has not been shown in a controlled study, however.

METHODS

We used monoclonal antibody-based enzyme immunoassays to detect astroviruses, enteric adenoviruses, and rotaviruses in stool samples obtained from age-matched children with and children without gastroenteritis. The samples were obtained in two studies, three years apart, among patients attending an outpatient clinic in Bangkok, Thailand.

RESULTS

In the first study, astroviruses were detected in 8.6 percent (96 of 1111) of the children with gastroenteritis and in 2.0 percent (19 of 947) of the children without gastroenteritis. In the second study the rates were 8.6 percent (50 of 580) and 2.1 percent (11 of 512), respectively. For both studies combined, enteric adenoviruses were detected in 2.6 percent of those with gastroenteritis and in 0.5 percent of the controls, whereas rotaviruses were detected in 19 percent of those with gastroenteritis and in 1.0 percent of the controls. The clinical findings associated with astrovirus infection were similar to those associated with rotavirus infection, except for a trend toward greater dehydration in the children infected with rotaviruses.

CONCLUSIONS

These two controlled studies involving a total of 3150 Thai children provide evidence that astroviruses are a common cause of viral gastroenteritis. Astroviruses were found in association with gastroenteritis more frequently than were enteric adenoviruses, and with nearly half the frequency of rotaviruses.

摘要

背景

星状病毒感染与儿童肠胃炎有关,血清学调查表明这种感染可能很常见。然而,在一项对照研究中尚未证实星状病毒作为肠胃炎病原体的重要性。

方法

我们使用基于单克隆抗体的酶免疫测定法,在年龄匹配的患肠胃炎和未患肠胃炎的儿童粪便样本中检测星状病毒、肠道腺病毒和轮状病毒。样本取自泰国曼谷一家门诊诊所的患者,两项研究间隔三年进行。

结果

在第一项研究中,患肠胃炎的儿童中有8.6%(1111例中的96例)检测到星状病毒,未患肠胃炎的儿童中有2.0%(947例中的19例)检测到。在第二项研究中,这一比例分别为8.6%(580例中的50例)和2.1%(512例中的11例)。两项研究合并来看,患肠胃炎的儿童中有2.6%检测到肠道腺病毒,对照组中有0.5%检测到;患肠胃炎的儿童中有19%检测到轮状病毒,对照组中有1.0%检测到。与星状病毒感染相关的临床症状与轮状病毒感染相关的症状相似,只是感染轮状病毒的儿童脱水倾向更明显。

结论

这两项涉及总共3150名泰国儿童的对照研究提供了证据,证明星状病毒是病毒性肠胃炎的常见病因。发现星状病毒与肠胃炎的关联比肠道腺病毒更频繁,与轮状病毒的关联频率接近其一半。

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