新生儿甲型流感6例临床分析

目的 探讨新生儿甲型流感的临床特点、诊断及治疗.方法 选择2009年11月至2010年2月本院新生儿内科病房收治的甲型流感患儿进行回顾性分析.结果 甲型流感患儿中新型甲型H1N1流感2例,患病前有感冒患者接触史4例,症状表现为发热、吐沫、咳嗽、呛奶、反应弱、纳差、腹泻.甲型流感病毒通用M基因阳性6例;猪H1N1流感病毒通用NP基因阳性2例;白细胞总数升高3例;分类以中性粒细胞为主4例;C反应蛋白升高3例;心肌酶升高4例;肝酶升高1例;胸部X线片示肺炎3例;心电图T波低平2例,ST段上移1例;血培养均阴性;脑脊液常规、生化均正常.6例患儿均未使用奥司他韦等抗病毒药物,以抗生素、中药以及保肝、营养心肌等对症支持治疗,预后良好.结论 新生儿甲型流感临床表现缺乏特异性,患儿可出现肺炎、心肌损害、肝功损害等并发症,但病程多具有自限性,预后较好,是否需应用奥司他韦等抗病毒药物有待探讨.

The clinical analysis of 6 neonates infected with influenza a virus

Objective To discuss the clinical features,diagnosis and treatment of neonates infected with influenza A virus.Methods Six neonates infected with influenza A virus admitted to our Neonatal Center from November 2009 to February 2010 were analyzed retrospectively.Results Among 6 neonates with influenza A virus,2 cases had the new type influenza A H1N1 infection.4 neonates had contacted with upper respiratory infection patient.The main clinical features included fever,spittling,cough,choking,weak reaction,anorexia,diarrhea.General influenza A virus(M gene) tests were positive in 6 cases,general swine influenza H1N1 virus(NP gene) tests were positive in 2 cases.Elevated white blood cells counts in 3 cases;higher percentage of neutrophilic granulocytes in 4 cases;Elevated C-reactive protein in 3 cases;Elevated cardiac enzymes in 4 cases;Elevated liver enzymes in 1 case;pneumonia diagnosed by CXR in 3 cases;flattened T wave of electrocardiogram in 2 cases;ST segment elevated in 1 case.Blood cultures were negative.CSF were normal.These neonates were treated with symptom-alleviating management,antibiotics,traditional Chinese medicine and liver and cardiac muscle protectant,without antiviral drug like oseltamivir.They were all recovered before discharging from hospital and had better prognosis.Conclusions Clinical manifestation of neonate A influenza was of no specificity.Neonate infected with influenza A might develop various complications,such as pneumonia,cardiac damage,abnormal liver function.However,these symptoms were self-limited with better prognosis.Whether antiviral treatment with drugs like oseltamivir was needed still required further discussion.