Biçer Suat, Çöl Defne, Küçük Öznur, Erdağ Gülay Ç, Giray Tuba, Uğraş Meltem, Vitrinel Ayça, Kaspar Çiğdem
Department of Child Health and Pediatrics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey -
Department of Child Health and Pediatrics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey.
Minerva Pediatr. 2018 Apr;70(2):165-174. doi: 10.23736/S0026-4946.16.04259-X.
Acute gastroenteritis is responsible for dehydration in many children. The viruses like rotavirus, norovirus, and adenovirus are considered the main causative agents of gastroenteritis. The goal of this study is the evaluation of the symptoms, clinical findings and hospitalization requirements in pediatric patients with dehydration secondary to viral gastroenteritis.
The distribution of age, symptoms, clinical and laboratory findings and hospitalization requirements of 156 viral acute gastroenteritis patients with moderate dehydration were evaluated retrospectively. Patients were between 3 months to 16 years of age (mean: 38.7 months). The patients were categorized into four groups according to etiological agents as rotavirus, norovirus, adenovirus, and mixed infections for the comparison of symptoms, clinical characteristics, laboratory results, seasonal distribution, treatment requirements, hospitalization unit, and hospitalization period. Age groups were categorized as 0-24 months, 25-72 months, and >72 months. Clinical characteristics of patients were analyzed for hospitalization period as <24 hours, and ≥24 hours.
Moderate-degree dehydration was detected in 156 patients with acute gastroenteritis (156/278) caused by rotavirus (60.5%), norovirus (58%) and adenovirus (42%) respectively. The common symptoms of all patients were vomiting, diarrhea, abdominal pain and malaise, although fever was seen mostly in the patients of rotavirus. Aspartat aminotransferase (AST) was elevated in rotavirus gastroenteritis (11.5%) more than norovirus (5.4%) and adenovirus (0.8%) infections. Elevated blood urea nitrogen (BUN) levels (>20 mg/dL) were shown in 79.3%, of patients especially in rotavirus (43.8%).
The main agents of acute gastroenteritis which caused dehydration were norovirus and rotavirus in our patients. Rotavirus was detected in most of the hospitalized patients with severe symptoms. AST was prominently elevated in rotavirus gastroenteritis. The clinical characteristics and some laboratory findings including hyperglycemia, leukocytosis, and elevated AST may be helpful in differentiating rotavirus from norovirus gastroenteritis. BUN level was insignificantly elevated in patients with rotavirus.
急性肠胃炎是导致许多儿童脱水的原因。轮状病毒、诺如病毒和腺病毒等病毒被认为是肠胃炎的主要病原体。本研究的目的是评估病毒性肠胃炎继发脱水的儿科患者的症状、临床发现及住院需求。
回顾性评估156例中度脱水的病毒性急性肠胃炎患者的年龄分布、症状、临床和实验室检查结果以及住院需求。患者年龄在3个月至16岁之间（平均：38.7个月）。根据病原体将患者分为四组，即轮状病毒、诺如病毒、腺病毒和混合感染组，以比较症状、临床特征、实验室结果、季节分布、治疗需求、住院科室和住院时间。年龄组分为0 - 24个月、25 - 72个月和>72个月。分析患者住院时间<24小时和≥24小时的临床特征。
在156例分别由轮状病毒（60.5%）、诺如病毒（58%）和腺病毒（42%）引起的急性肠胃炎患者中检测到中度脱水（156/278）。所有患者的常见症状为呕吐、腹泻、腹痛和不适，不过发热在轮状病毒感染患者中最为常见。轮状病毒肠胃炎患者中天冬氨酸转氨酶（AST）升高（11.5%）的比例高于诺如病毒（5.4%）和腺病毒（0.8%）感染患者。79.3%的患者血尿素氮（BUN）水平升高（>20mg/dL），尤其是轮状病毒感染患者（43.8%）。
在我们的患者中，导致脱水的急性肠胃炎的主要病原体是诺如病毒和轮状病毒。大多数症状严重的住院患者检测到轮状病毒。轮状病毒肠胃炎中AST显著升高。包括高血糖、白细胞增多和AST升高在内的临床特征及一些实验室检查结果可能有助于区分轮状病毒和诺如病毒肠胃炎。轮状病毒感染患者中BUN水平升高不明显。
