191例甲型H1N1流感临床分析

目的 了解甲型H1N1流感患者的临床特征和危险因素,以期对今后的诊疗工作有所借鉴.方法 回顾我院2009年6-11月经实验室确诊的191例甲型H1N1流感病例的临床资料,分析患者发病特点、治疗和临床过程、重症病例危险因素.结果 大多数甲型H1N1流感患者起病较为温和,主要症状有发热(100%)和(或)咳嗽(87.4%),极少数患者出现卡他症状和消化道症状.191例患者伴基础疾病者21例;16例重症病例,6例需ICU治疗.C反应蛋白(CRP)升高与住院天数和疾病严重程度呈正相关(r=0.462,P＜0.01);胸片异常者住院天数和CRP值与正常者比较差异均有统计学意义(t=2.545,t=4.440,P＜0.05),并有可能需要收住ICU进一步治疗.60例患者服用奥司他韦抗病毒治疗,176例患者予中医辨证治疗,均显示较好疗效.结论 CRP与胸片检查可能有助于甲型H1N1流感重症患者的早期筛查.中医治疗对甲型H1N1流感有一定效果,尤其对于减轻咳嗽、头痛、咽痛等症状效果较为显著.

Clinical analysis of 191 cases of influenza A (H1N1)

Objective To analyze the clinical characteristics and risk factors of influenza A (H1N1) patients,which would benefit the clinical practices for diagnosis and treatment of influenza A (H1N1) in the future. Methods The clinical information of 191 cases of laboratory-confirmed influenza A (H1N1) in our hospital from June to November 2009 were reviewed, and the clinical characteristics, risk factors, treatment and clinical course of influenza A (H1N1) patients were analyzed. Results In 191 influenza A (H1N1) patients, the majority presented mildly with fever(100%) and(or) cough(87.4%), a very small number of patients had catarrhal symptoms and gastrointestinal symptoms. 21 cases had underlying diseases. In 16 severe cases, 6 patients were admited to intensive care unit(ICU). The levels of C-reactive protein (CRP) increasing were positively correlated with the hospitalization days and disease severity(r=0.462, P＜0.01). Patients with abnormal changes on chest X-ray had significantly longer hospitalization time and higher CRP level(t=2.545, t=4.440, P＜0.05), and needed to admit to ICU for further treatment. 60 cases were given oseltamivir for antiviral therapy, 176 patients were given traditional Chinese medicine for dialectical therapy, and both showed good efficacy. Conclusions CRP level and the chest X-ray examination may be useful in the early detection of severe influenza A (H1N1) patients. Traditional Chinese medicine treatment of influenza A (H1N1) is proved to have a certain effect, especially for reducing cough, headache, sore throat symptoms.