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中华消化病与影像杂志(电子版) ›› 2026, Vol. 16 ›› Issue (03) : 278 -283. doi: 10.3877/cma.j.issn.2095-2015.2026.03.016

论著

电解质紊乱与凝血功能异常对轮状病毒肠炎患儿补液治疗失败的预测价值
沈燕1, 施金金2, 陈颖青2, 钮文思2, 龚恬安2,()   
  1. 1215200 江苏省,苏州市第九人民医院儿科
    2215200 江苏省,苏州市吴江区儿童医院消化感染科
  • 收稿日期:2025-10-17 出版日期:2026-06-01
  • 通信作者: 龚恬安

Predictive value of electrolyte imbalance and abnormal coagulation function for the failure of fluid replacement treatment in children with rotavirus enteritis

Yan Shen1, Jinjin Shi2, Yingqing Chen2, Wensi Niu2, Tian'an Gong2,()   

  1. 1Department of Pediatrics, Suzhou Ninth People's Hospital, Suzhou 215200, China
    2Department of Digestive and Infectious Diseases, Suzhou Wujiang District Children's Hospital, Suzhou 215200, China
  • Received:2025-10-17 Published:2026-06-01
  • Corresponding author: Tian'an Gong
引用本文:

沈燕, 施金金, 陈颖青, 钮文思, 龚恬安. 电解质紊乱与凝血功能异常对轮状病毒肠炎患儿补液治疗失败的预测价值[J/OL]. 中华消化病与影像杂志(电子版), 2026, 16(03): 278-283.

Yan Shen, Jinjin Shi, Yingqing Chen, Wensi Niu, Tian'an Gong. Predictive value of electrolyte imbalance and abnormal coagulation function for the failure of fluid replacement treatment in children with rotavirus enteritis[J/OL]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2026, 16(03): 278-283.

目的

电解质紊乱与凝血功能异常对轮状病毒肠炎(RE)患儿补液治疗失败的预测价值。

方法

回顾性选取2021年2月至2025年2月于苏州市吴江区儿童医院行补液治疗的268例RE患儿的临床资料,根据补液治疗结局分为治疗成功组(n=207)与治疗失败组(n=61)。比较两组患儿入院时的电解质及凝血功能指标水平。Spearman相关性分析电解质紊乱、凝血功能与RE患儿补液治疗失败的相关性,多因素Logistic回归分析筛选补液治疗失败的独立危险因素,并通过受试者工作特征(ROC)曲线评估其预测效能。

结果

治疗失败组C反应蛋白(CRP)、降钙素原水平高于治疗成功组,血钠、血钾、血钙水平均低于治疗成功组,差异有统计学意义(均P<0.05)。治疗失败组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均高于治疗成功组,纤维蛋白原(FIB)低于治疗成功组,差异均有统计学意义(P<0.05)。Spearman相关性显示,血钠、血钾、血钙及FIB水平与RE患儿补液治疗失败均呈负相关,PT、APTT水平与RE患儿补液治疗失败呈正相关(P<0.05)。二元logistic显示,高CRP、低血钠、低血钾、高APTT、低FIB水平是RE患儿补液治疗失败的独立危险因素(P<0.05)。ROC显示,CRP、血钠、血钾、APTT、FIB及联合检测对补液治疗失败均表现出一定的预测价值,其AUC分别为0.767、0.780、0.751、0.764、0.731、0.941,灵敏度分别为0.590、0.449、0.643、0.623、0.483、0.885,特异度为0.836、0.967、0.787、0.787、0.918、0.894,联合检测的ROC AUC高于各单项独立预测(均P<0.05)。

结论

CRP、血钠、血钾、APTT、FIB是RE患儿补液治疗失败的独立危险因素,上述指标联合检测可显著提高对治疗失败的预测效能。

Objective

To explore the predictive value of electrolyte imbalance and abnormal coagulation function for the failure of fluid replacement therapy in children with rotavirus enteritis (RE).

Methods

The clinical data of 268 children with RE who underwent fluid replacement treatment in Suzhou Wujiang District Children's Hospital from February 2021 to February 2025 were selected. According to the outcome of fluid replacement treatment, they were divided into the successful treatment group (n=207) and the failed treatment group (n=61). The levels of electrolytes and coagulation function indicators of the two groups of children at admission were compared. Spearman correlation analysis was conducted to investigate the correlation between electrolyte imbalance, coagulation function and the failure of fluid replacement therapy in children with RE. Multivariate Logistic regression analysis was used to screen for independent risk factors of fluid replacement therapy failure, and the predictive efficacy was evaluated through the receiver operating characteristic (ROC) curve.

Results

The levels of C-reactive protein (CRP) and procalcitonin in the treatment failure group were higher than those in the treatment success group, while the levels of blood sodium, blood potassium and blood calcium were all lower than those in the treatment success group, with statistically significant differences (all P<0.05). The prothrombin time (PT) and activated partial thromboplastin time (APTT) values in the treatment failure group were both higher than those in the treatment success group, while the fibrinogen (FIB) value was lower than that in the treatment success group, with statistically significant differences (all P<0.05). Spearman correlation showed that the levels of blood sodium, blood potassium, blood calcium and FIB were negatively correlated with the failure of fluid replacement treatment in children with RE, while the levels of PT and APTT were positively correlated with the failure of fluid replacement treatment in children with RE (all P<0.05). Binary logistic showed that high CRP, low blood sodium, low blood potassium, high APTT, and low FIB levels were independent risk factors for the failure of fluid replacement treatment in children with RE (all P<0.05). ROC showed that CRP, blood sodium, blood potassium, APTT, FIB and combined detection all demonstrated certain predictive values for the failure of fluid replacement therapy, with AUCs of 0.767, 0.780, 0.751, 0.764, 0.731 and 0.941, respectively. The sensitivities were 0.590, 0.449, 0.643, 0.623, 0.483, and 0.885 respectively, and the specificities were 0.836, 0.967, 0.787, 0.787, 0.918, and 0.894. Moreover, the ROC AUC of the combined detection was higher than that of each individual independent prediction (all P<0.05).

Conclusion

CRP, blood sodium, blood potassium, APTT, and FIB are independent risk factors for the failure of fluid replacement therapy in children with RE, and the combined detection of the above indicators can significantly improve the predictive efficacy for treatment failure.

表1 两组轮状病毒肠炎患儿一般临床资料
表2 两组轮状病毒肠炎患儿电解质水平(±s
表3 两组轮状病毒肠炎患儿凝血功能指标(±s
表4 电解质紊乱、凝血功能与轮状病毒肠炎患儿补液治疗失败的相关性分析
表5 Logistic回归分析轮状病毒肠炎患儿补液治疗失败的独立危险因素
图1 轮状病毒肠炎患儿补液治疗失败各影响因素的ROC曲线
表6 各独立影响因素单独及联合对轮状病毒肠炎患儿补液治疗失败的预测效能
[1]
卢贤红, 钱石陆, 周敏. 微生态调节剂对小儿轮状病毒性肠炎的临床干预效果分析[J/OL]. 中华消化病与影像杂志(电子版), 2023, 13(4): 245-249.
[2]
Geng X, Cao X, Jiang J, et al. Relationship between fecal viral load and peripheral blood Th1/Th2, related cytokines in children with rotavirus infection enteritis[J]. Microbial Pathogenesis, 2025, 206: 107745.
[3]
朱瑞, 赵青. 2018—2021年山西地区1283例住院病儿轮状病毒肠炎的流行病学特征及临床分析[J]. 安徽医药, 2024, 28(9): 1880-1884.
[4]
卢美娜, 华春珍. 小儿轮状病毒肠炎并发良性惊厥临床特征及危险因素分析[J]. 创伤与急危重病医学, 2022, 10(5): 374-376.
[5]
Sandora TJ. Rotavirus Vaccination in the NICU: It's Time to Turn Opportunity Into Action[J]. Pediatrics, 2025, 155(1): 2.
[6]
朱英莉, 王延玲. 醒脾养儿颗粒结合蒙脱石散治疗轮状病毒性肠炎患儿的临床疗效以及对炎症因子和心肌酶谱水平的影响[J]. 中国医药导刊, 2022, 24(7): 687-691.
[7]
George JA, Al-Marzooq F, Narchi H, et al. Identification of Rotavirus Genotypes in Children under Five Years in the United Arab Emirates Using Nanopore Sequencing Technology[J]. J Med Virol, 2024, 96(11): e70056.
[8]
长三角免疫规划一体化项目组, 中华医学会感染病学分会儿童感染和肝病学组. 儿童轮状病毒胃肠炎预防诊疗专家共识(2020年版)[J]. 中华预防医学杂志, 2020, 54(4): 392-405.
[9]
中国腹泻病诊断治疗方案[J]. 中国实用儿科杂志, 1998,(6): 61-64.
[10]
Jimmy M, Kumbhakar RG, Amanda C, et al. Outbreak of Rotavirus Diarrheal Infection Among Adults in King County, Washington, January–June 2023[J]. J Infect Dis, 2025, 231(6): 1553-1558.
[11]
魏莹亚. 口服补液盐Ⅲ联合双歧杆菌四联活菌片治疗小儿轮状病毒肠炎疗效观察[J]. 山西医药杂志, 2022, 51(5): 558-559.
[12]
马孟琦, 张川波, 高志伟, 等. 参歧肠泰合剂联合口服补液盐散(Ⅲ)治疗儿童感染性腹泻的临床研究[J]. 现代药物与临床, 2024, 39(10): 2582-2586.
[13]
Joshua P, Ceri E, Bernard C, et al. Associations Between Histo-blood Group Antigen Status in Mother-Infant Dyads and Infant Oral Rotavirus Vaccine Immunogenicity in Rural Zimbabwe[J]. J Infect Dis, 2024, 231(1): e225-e233.
[14]
李琼琼, 周莹, 苏快乐, 等. 乳果糖联合口服补液盐散(Ⅲ)对结肠镜检查前肠道准备的效果及病变检出率的影响[J]. 中国基层医药, 2025, 32(4): 527-532.
[15]
解荣, 韦国栋, 陈闫, 等. 血清Hcy、PTX3对小儿轮状病毒肠炎合并心肌损害的预测效能[J]. 分子诊断与治疗杂志, 2025, 17(2): 330-333.
[16]
Ye Q, Zhang Z, Chen T, et al. Fecal gut microbiome alterations and its association with lactose intolerance in children with rotavirus infection–related diarrhea[J]. Eur J Pediatr, 2025, 184(9): 553.
[17]
唐甜甜, 王军, 徐鹏飞, 等. 轮状病毒肠炎惊厥的临床特点及惊厥多发危险因素分析[J]. 中国医师进修杂志, 2023, 46(6): 481-487.
[18]
Fukuda Y, Kusuhara H, Takai-Todaka R, et al. Human transmission and outbreaks of feline-like G6 rotavirus revealed with whole- genome analysis of G6P feline rotavirus[J]. J Med Virol, 2024, 96(4): e29565.
[19]
刘虎, 郭长江, 田常营. 轮状病毒肠炎致心肌损伤的影响因素及其与血清IgA、IgG、hs-CRP的关联[J]. 分子诊断与治疗杂志, 2023, 15(11): 1882-1885, 1894.
[20]
李春燕, 许丽丹, 宋霜. 儿童轮状病毒肠炎并发惊厥的危险因素及列线图预测模型构建[J]. 临床和实验医学杂志, 2023, 22(1): 77-80.
[21]
Mwenda JM, Inácio M, Worwui AK, et al. A decade of rotavirus vaccination in the World Health Organization African Region: An in-depth analysis of vaccine coverage from 2012 to 2023[J]. Vaccine, 2025, 48: 126768.
[22]
杜宝静, 关江峰, 申永静, 等. 重组人干扰素α2b联合1, 6-二磷酸果糖对轮状病毒肠炎患儿胃肠激素及炎症因子水平的影响[J]. 中国现代医学杂志, 2024, 34(22): 89-93.
[23]
韩彩云, 马娇, 李燕. 血清PAF和sTM水平与小儿轮状病毒肠炎及脱水程度的相关性研究[J/OL]. 中华消化病与影像杂志(电子版), 2025, 15(1): 83-88.
[24]
Parviainen A, But A, Sund R, et al. Incidence of Type 1 Diabetes in Relation to Exposure to Rotavirus Infections in Pre- and Postvaccine Birth Cohorts in Finland[J]. Diabetes Care, 2024, 47(1): 97-100.
[25]
范映莉, 李敏艳, 李晓芳. 布拉酵母菌联合口服补液盐治疗小儿轮状病毒肠炎疗效分析[J]. 山西医药杂志, 2022, 51(22): 2568-2570.
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