Ruuska T, Vesikari T
Department of Paediatrics, Tampere University Central Hospital, Finland.
Acta Paediatr Scand. 1991 May;80(5):500-7. doi: 10.1111/j.1651-2227.1991.tb11893.x.
To determine the incidence, clinical significance and etiology of acute diarrhoea in early childhood, a cohort of 336 children were followed from birth to the age of 24-32 (mean 26) months. More than half (55%) of the children had no diarrhoea, 26% had one episode and 19% had two or more episodes of diarrhoea during follow-up; altogether 248 episodes of diarrhoea were detected. Rotavirus was by far the most common (26%) identified pathogen; adenoviruses were detected in 4% and bacterial pathogens (EPEC, Salmonellae, Yersiniae) in 4% of the cases. Two thirds of the episodes remained etiologically unresolved. Rotavirus diarrhoea was significantly more severe than diarrhoea due to other causes; 75% of severe episodes of diarrhoea were associated with rotavirus. About two thirds of the infants were breast-fed over 6 months; breast-feeding for less than 6 months was associated with a higher incidence of rotavirus diarrhoea between 7-12 months of age but not thereafter. About three quarters of the children were cared for at home beyond 12 months of age; those at home had a lower rate of rotavirus diarrhoea than those at day-care centers.
为了确定幼儿期急性腹泻的发病率、临床意义和病因,对336名儿童进行了队列研究,从出生一直跟踪到24 - 32个月(平均26个月)。超过半数(55%)的儿童未出现腹泻,26%的儿童有过一次腹泻发作,19%的儿童在随访期间有两次或更多次腹泻发作;共检测到248次腹泻发作。轮状病毒是迄今为止最常见的(26%)已确定病原体;4%的病例中检测到腺病毒,4%的病例中检测到细菌病原体(肠致病性大肠杆菌、沙门氏菌、耶尔森氏菌)。三分之二的腹泻发作在病因上仍未明确。轮状病毒腹泻比其他原因引起的腹泻明显更严重;75%的严重腹泻发作与轮状病毒有关。约三分之二的婴儿母乳喂养超过6个月;6个月以内母乳喂养与7至12个月龄时轮状病毒腹泻的较高发病率相关,但12个月龄之后则无此关联。约四分之三的儿童在12个月龄之后在家中照料;在家中照料的儿童轮状病毒腹泻发生率低于日托中心的儿童。