·182·中国感染控制杂志2010年5月第9卷第3期ChinJInfectControlVol9No3May2010细菌性痢疾与其他感染性腹泻的早期临床对比分析乔文颖，李晓辉，刘士栩，胡明(北京潞河医院，北京101149)．1床研究．[摘要]目的对比研究细菌性痢疾(简称菌痢)和其他感染性腹泻的流行病学及II伍床症候特点，以提高临床医生对二者的非细菌学简易鉴别能力。方法对140例临床菌痢与349例其他感染性腹泻患者的流行病学和临床资料进行对比研究，同时再通过多因素分析筛选鉴别两者的相关因素。结果菌痢与其他感染性腹泻好发季节有所不同(P<0．05)，前者夏季多发，后者秋季更为多见。菌痢患者发热、里急后重、黏液便、脓血便及左下腹压痛较其他感染性腹泻多见，而后者以恶心呕吐、水样便及稀便较多见，差异均有显著性(均P<0．05)。二分类Logistic回归分析发现，发病季节、里急后重、发热、大便性状及左下腹压痛5个因素与菌痢的诊断密切相关。结论发热、里急后重、黏液便及左下腹压痛是临床诊断菌痢和其他感染性腹泻的主要鉴别点。[关键词]腹泻；痢疾；感染性腹泻；鉴别诊断[中图分类号]R516．4[文献标识码]AE3t章编号]1671—9638(2010)03—0182—04Comparisonbetweenbacillarydysenteryandotherinfectivediarrheadur—ingearlyclinicalstageQIAOWen～ying，LIXiao—hui，IIUShi—zM，HUYue(BeijingLuheHospital，Beijing101149。Cina)[-Abstract]ObjectiveTocomparetheepidemiologicalandclinicalcharacteristicsofbacillarydysenteryandotherinfectivediarrheaforbetternon-bacteriologicaldiagnosisanddifferentialdiagnosis．MethodsEpidemiologyandclinicalmanifestationsof140bacillarydysenteryand349otherinfectivediarrheacaseswereretrospectivelystudied，Logisticregressionanalysiswasusedtoscreentherelatedfactorsfordifferentiatingbacillarydysenteryfromotherinfectivediarrhea．ResultsPeakseasonaldifferencewasfoundstatisticallysignificantintheoccurrencerateofbac—illarydysenteryandotherinfectivediarrhea(P％0．05)，theformerwasinsummertimeandthelatterinautum．Fe—ver，tenesmus，mHeousstool，pusandbloodstoolandtendernessonleftlowerquadrantwerefoundmorefrequentinbacillarydysenterycasesthaninotherinfectivediarrhea，butnausea，vomiting，waterystoolandloosestoolswerethemainclinicalcharacteristicsofthelatter(allP
