The Association of Intussusception and Adenovirus Infection in Children: A Single Center Study in Taiwan

小兒腸套疊與腺病毒感染之關係：一醫學中心之研究

陳俊彥(Chun-Yen Chen) ； 林隆煌(Lung-Huang Lin)

《輔仁醫學期刊》 11卷4期 (2013/12) Pp. 297-304

摘要

小兒腸套疊為兒科常見的急症，通常發生在小於兩歲的嬰幼兒上，許多病原都被證實與腸套疊有關，當中尤其以腺病毒為最。本篇研究蒐集了台灣一醫學中心自2008年到2011年的腸套疊案例，分析其中的主要臨床徵狀、確診方式、各個時間的發生率。腺病毒，顧名思義，乃是因其對腺體、淋巴組織有強力感染而得名，其潛伏期是5－7天，容易侵犯6個月至5歲小孩，佔兒童呼吸道感染5－20%，一般秋、春以呼吸道感染為多，春、初夏以合併結膜炎為多，大部份由飛沫傳染，少部份由糞便接觸感染，培養病毒主要由喉嚨、結膜、糞便三處。疾病的過程約5－7天，也有進入第二星期的，感染2－3星期後產生抗體，可持續一至數年，同型病毒再感染的機率很少，腺病毒1，2，5，6血清型已被證實與腸套疊有密切相關。此研究蒐集了同段時間內由喉頭腺病毒抗原快篩及病毒培養檢驗出腺病毒感染陽性的個案，再將腸套疊個案與腺病毒個案兩者加以分析比較。我們發現在2011年四、五、六月曾經有一波腸套疊發生，同時也是腺病毒感染的高峰期，可以推斷兩者明顯有關連性。

關鍵字

腸套疊 ； 腺病毒

並列摘要

Background and purpose: The aim of this study was to explore the association of intussusception and adenovirus infection in children. Methods: From January 2008 to June 2011, patients admitted for intussusception in a single hospital were enrolled. Diagnosis was based on the patient's clinical presentation, abdominal sonography findings, and lower gastrointestinal (GI) tract series. The rate of each clinical symptom was analyzed. In-patients with adenovirus infection confirmed by viral isolation or antigen test from throat swab during the same period were also identified. Correlations between intussusception and adenovirus infection were made. Results: There were 34 children admitted to the pediatric ward for intussusception during the study period, including 12 (35.29%) who were diagnosed in April, May, and June 2011. In the study period, there were 512 patients with positive adenovirus culture and 123 with positive adenovirus antigen, including 172 (33.60%) with positive adenovirus culture and 61 (49.60%) with positive adenovirus antigen in the same three months of April, May, and June 2011. Conclusions: Spring and early summer (April, May, and June 2011) are the periods with the highest incidences of intussusception and adenovirus infections. Thus, adenovirus infection may be related to the pathogenesis of intussusception.

並列關鍵字

adenovirus ； intussusception