105例儿童甲型H1N1流感病例流行病学与临床特征分析

目的探讨甲型H1N1流感患儿的流行特点及临床特征,为甲型H1N1流感的诊疗和预防提供依据。方法 以湖南省儿童医院2009年10月27日-2010年2月27日收治的105例实验室确诊甲型H1N1流感病例为研究对象,回顾性分析其流行病学和临床特征。结果1.105例甲型H1N1流感患儿以男性为主,高发年龄为0~5岁,大部分来自城镇,50.5%有接触史,90.5%患儿入院时间集中在11月、12月份。34例（32.4%）以其它疾病入院。2.临床表现无特异性。咳嗽、发热为其普遍症状,部分患儿出现呕吐、腹泻及头痛症状。24例（22.9%）患儿存在基础疾病。3.白细胞下降主要发生在婴儿;WBC升高主要见于1岁以上患儿。ESR、CRP、PCT等炎性指标及CK、AST、BAMS等酶学指标异常广泛。早期胸片改变较临床明显。4.重症及危重症病例占到71.5%。肺炎为最常见并发症,发生率为80.0%,呼吸衰竭为最严重并发症,发生率为18.1%。结论儿童甲型H1N1流感无特异表现,病情相对温和;但在部分儿童,特别是有基础病史者可表现为重症;门诊血常规、胸片检查有助于早期发现重症。

Analysis on Epidemiological and Clinical Characteristics of 105 Children with Influenza A(H1N1)

Objective To explore the epidemiological and clinical features of influenza A(H1N1),and to provide the evidence for diagnosis,treatment and prevention of influenza A(H1N1). Methods Totally 105 cases of laboratory-confirmed influenza A(H1N1)admitted to Children’s Hospital of Hunan Province from October 27,2009 to February 27,2010 were selected as the research objects.The epidemiological and clinical features of these cases were retrospectively analyzed. Results The number of boys who had influenza A(H1N1) among the 105 cases was more than that of girls,and most of them were between 0 to 5 years old.Most of the cases came from towns,50.5% of them had a contact history before being infected.The time admitted to the hospital focused in November and December,2009.34 patients(32.4%) were hospitalized for other diseases.There was no clinical manifestation specificity.Cough and fever were the common symptoms.Some patients had vomiting,diarrhea and headache.24 patients(22.9%) had underlying diseases.Leukopenia was found in many children who were under 5 years old,especially the infants.An increase in WBC was mainly seen in children over 1 year old.The inflammatory markers such as ESR,CRP,PCT and the indicators of enzyme such as CK,AST,and BAMS were abnormal widely.Chest radiograph abnormalities were more common than clinical manifestations at early onset.Severe cases accounted for 71.5%.Pneumonia was the most common complication,with the incidence rate of 80.0%.The most serious complication was respiratory failure,with the incidence rate of 18.1%. Conclusions There were no specific clinical manifestations and symptoms of influenza A(H1N1),and the condition was relatively mild.But the severe cases might occur in children,especially in those with underlying diseases.Clinical blood test and chest X-ray examination are conducive to early detection of severe cases.