Wang Di-Ying, Zhan Feng, Liu Hui-Ling
Department of Clinical Laboratory, Changzhou Tumor Hospital Affiliated to Soochow University, Changzhou, China.
Transl Pediatr. 2021 Oct;10(10):2544-2551. doi: 10.21037/tp-21-433.
Infectious diarrhea is a serious hazard to children under 5 years old. The causative microorganisms are mostly viruses and bacteria, with different treatment required for each. Currently, early clinical differential diagnosis is difficult with the available testing methods. Therefore, new and more sensitive indicators of viral infection reflect the early stage of infection are needed.
We collected blood samples and fresh fecal samples from 100 children diagnosed with viral diarrhea who were treated in the outpatient clinic at Changzhou Tumor Hospital Affiliated to Soochow University from January 2018 to December 2020. The levels of interleukin-2 (IL-2), IL-6, tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) in serum, the erythrocyte sedimentation rate (ESR) and enterovirus were measured and compared with those in a matched healthy control group. Patients' demographic and risk factor data were collected by interviewing parents.
The mean levels of IL-2, IL-6, TNF-α, ESR, and CRP in the viral diarrhea group were higher than those in the healthy control group. Except for IL-6, the differences in inflammatory factors between groups were statistically significant (P<0.05). Human rotavirus (HRV) infection was the highest. Children's hand-washing habits, weekly disinfection of toys, and vaccination were protective factors for viral diarrhea, and indoor flies were an important risk factor (P<0.05).
The serum levels of markers were significantly increased in the children with viral diarrhea. HRV was the main pathogen, and mixed infections existed. Infection control requires hand washing, regular disinfection of toys, vaccination and preventing indoor flies.
感染性腹泻对5岁以下儿童是严重危害。致病微生物大多是病毒和细菌，每种所需治疗不同。目前，现有的检测方法难以进行早期临床鉴别诊断。因此，需要新的、更敏感的反映病毒感染早期阶段的指标。
我们收集了2018年1月至2020年12月在苏州大学附属常州肿瘤医院门诊治疗的100例诊断为病毒性腹泻儿童的血样和新鲜粪便样本。检测血清中白细胞介素-2（IL-2）、IL-6、肿瘤坏死因子-α（TNF-α）和C反应蛋白（CRP）水平、红细胞沉降率（ESR）及肠道病毒，并与匹配的健康对照组进行比较。通过询问家长收集患者的人口统计学和危险因素数据。
病毒性腹泻组IL-2、IL-6、TNF-α、ESR和CRP的平均水平高于健康对照组。除IL-6外，各组间炎症因子差异有统计学意义（P<0.05）。人轮状病毒（HRV）感染率最高。儿童洗手习惯、每周玩具消毒和接种疫苗是病毒性腹泻的保护因素，室内苍蝇是重要危险因素（P<0.05）。
病毒性腹泻儿童血清标志物水平显著升高。HRV是主要病原体，存在混合感染。感染控制需要洗手、定期玩具消毒、接种疫苗和防止室内苍蝇。
