Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Memorial Hospital, Italy.
J Pediatr Gastroenterol Nutr. 2009 Nov;49(5):580-3. doi: 10.1097/MPG.0b013e31819bcbd2.
: Abdominal pain-related functional gastrointestinal disorders (AP-FGIDs) following bacterial acute gastroenteritis (AGE) have been demonstrated in adults and children. An adult study demonstrated AP-FGIDs resulting from an outbreak of viral AGE. Viral AGEs are common in children. Thus, the demonstration of AP-FGIDs occurring after a viral infection in children could constitute a significant finding. The aim of the study was to investigate the development of FGIDs following an episode of acute rotavirus gastroenteritis in children. This is the first pediatric multicenter study designed to assess postviral AP-FGIDs.
: It is a cohort study. Inclusion criteria of the study are children ages 4 to 18 years with history of AGE secondary to rotavirus. Sample size is 44 exposed and 44 controls (unidirectional alpha of 0.05, power of 0.80). Children consulting at 2 hospitals (Chicago, IL, and Naples, Italy) for AGE (2002-2004) who tested positive for rotavirus were randomly contacted by telephone >2 years after the episode. Each exposed child who visited the emergency department or outpatient site for acute trauma or well-child visit within 4 weeks of the index case was matched with a control of the same age and sex. Gastrointestinal symptoms and disability were evaluated with a validated pediatric questionnaire.
: Eighty-eight patients (46 boys, mean age 5.3 years) were recruited. Contacted patients presented with AGE in 2002 (9), 2003 (11), and 2004 (24). Seven (16%) exposed patients and 3 (7%) controls reported AP-FGIDs (P = 0.31).
: Our study suggests that rotavirus infection does not seem to place children at increased risk for AP-FGIDs at long-term follow-up. Larger, prospective studies should be conducted to evaluate whether rotavirus gastroenteritis leads to AP-FGIDs in children.
在成人和儿童中，细菌性急性肠胃炎（AGE）后出现的与腹痛相关的功能性胃肠道疾病（AP-FGIDs）已得到证实。一项成人研究表明，病毒性 AGE 暴发会导致 AP-FGIDs。病毒性 AGE 在儿童中很常见。因此，在儿童感染病毒后出现 AP-FGIDs 可以构成重要发现。本研究旨在调查儿童急性轮状病毒肠胃炎后 FGIDs 的发生情况。这是第一项设计用于评估病毒性 AGE 后 AP-FGIDs 的儿科多中心研究。
这是一项队列研究。该研究的纳入标准为年龄在 4 至 18 岁之间、有轮状病毒引起的 AGE 病史的儿童。样本量为 44 名暴露组和 44 名对照组（单侧α为 0.05，功率为 0.80）。2002-2004 年在伊利诺伊州芝加哥和意大利那不勒斯的 2 家医院因 AGE 就诊且轮状病毒检测阳性的患儿通过电话随机联系，时间超过 2 年。每个暴露组患儿在索引病例后 4 周内因急性创伤或常规儿童就诊到急诊室或门诊就诊时，都与年龄和性别相同的对照组患儿匹配。采用经过验证的儿科问卷评估胃肠道症状和残疾。
共招募了 88 名患者（46 名男性，平均年龄 5.3 岁）。联系到的患儿于 2002 年（9 例）、2003 年（11 例）和 2004 年（24 例）发生 AGE。7 名（16%）暴露组患儿和 3 名（7%）对照组患儿报告出现 AP-FGIDs（P=0.31）。
本研究表明，轮状病毒感染似乎不会使儿童在长期随访中面临更高的 AP-FGIDs 风险。应进行更大规模的前瞻性研究，以评估轮状病毒肠胃炎是否会导致儿童出现 AP-FGIDs。
