无症状轮状病毒感染与新生儿黄疸的关系：一项回顾性研究。
Relationship between asymptomatic rotavirus infection and jaundice in neonates: a retrospective study.
机构信息
Department of Pediatrics, Chonbuk National University Medical School, 20, Geonjiro Deokjin-gu, Jeonju-si, Jeollabuk-do, 54907, South Korea.
Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
出版信息
BMC Pediatr. 2018 Nov 30;18(1):376. doi: 10.1186/s12887-018-1352-z.
BACKGROUND
Rotavirus (RV) infection in neonates can be mild or even asymptomatic. In RV infection, jaundice is often reported, but the relationship between jaundice and RV infection has not been studied. This study aimed to determine the importance of asymptomatic RV screening in neonates with jaundice.
METHODS
Neonates from the neonatal intensive care unit (NICU) of Chonbuk National University Hospital, those transferred from local obstetrics and gynecology hospitals and outpatient clinics were selected from 2014 to 2017. The study included only infants aged between 3 and 28 days. Jaundice was defined according to gestational age and birth age, in accordance with the American Academy of Pediatrics guidelines criteria. RV infection was confirmed by a stool test, and RV screening and laboratory tests were performed at admission.
RESULTS
Among 596 patients, 166 patients had jaundice. RV infection was observed in 70 (42%) jaundice patients. There were 36 (22%) jaundice patients with asymptomatic RV infection. Patients with onset of jaundice 3-7 days after birth had a high incidence of RV infection. When the RV test was positive, the risk of jaundice was significantly high [odds ratio (OR) 1.89; 95% confidence interval (CI), 1.20-2.98; p = 0.006].
CONCLUSIONS
Infants with the onset of jaundice > 3 days after birth were likely to have RV infection. Therefore, we suggest that screening tests for RV infection be included as part of the evaluation of jaundiced infants presenting to NICU.
背景
新生儿轮状病毒 (RV) 感染可表现为轻症甚至无症状。在 RV 感染中，黄疸常被报道，但黄疸与 RV 感染之间的关系尚未得到研究。本研究旨在确定对黄疸新生儿进行无症状 RV 筛查的重要性。
方法
本研究纳入了 2014 年至 2017 年期间，来自全罗北道国立大学医院新生儿重症监护病房（NICU）、从当地妇产科医院和门诊转来的新生儿。仅纳入胎龄 3 至 28 日的婴儿。黄疸根据美国儿科学会指南标准，按照胎龄和出生年龄定义。通过粪便检查确认 RV 感染，入院时进行 RV 筛查和实验室检查。
结果
在 596 例患者中，166 例有黄疸。70 例（42%）黄疸患者中观察到 RV 感染。36 例（22%）黄疸患者有无症状 RV 感染。出生后 3-7 天出现黄疸的患者 RV 感染发生率较高。当 RV 检测呈阳性时，黄疸的风险显著增加[比值比（OR）1.89；95%置信区间（CI），1.20-2.98；p=0.006]。
结论
出生后黄疸发作 >3 天的婴儿可能有 RV 感染。因此，我们建议将 RV 感染筛查作为 NICU 就诊黄疸婴儿评估的一部分。
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