流感样症状患者临床特征分析

目的分析中山大学孙逸仙纪念医院急诊留观区2018年9月至2019年1月接诊的流感样症状患者的临床特征，为流感患者诊治提供依据。 方法选择2018年9月至2019年1月中山大学孙逸仙纪念医院急诊接诊的180例流感样症状患者，比较不同月份的发病例数。按流感快速抗原检测结果分为流感组与非流感组，流感组为临床诊断为流行性感冒的患者90例，其中男性31例，女性59例；年龄15～94岁，平均(36.82±16.43)岁。非流感组按照与流感组相同的性别年龄比例选取90例有流感症状但不符合临床诊断标准的患者，其中男性32例，女性58例；年龄17～89岁，平均(37.35±15.59)岁。两组患者的性别年龄组成比例差异无统计学意义。分析比较2组的血常规白细胞计数、淋巴细胞计数、嗜酸性粒细胞计数及临床症状，并比较各种观察指标之间的流感快速抗原检出率。 结果流感在12月及1月发病例数高于其他月份。流感组的白细胞及淋巴细胞计数低于非流感组(6.71±2.40)×10⁹/L vs (9.08±4.91)×10⁹/L，(0.97±0.49)×10⁹/L vs (1.29±0.75)×10⁹/L]；常见临床症状中流感快速抗原检测阳性率分别为：低热13例(40.60%)，中度热46例(54.80%)，高度热42例(56.0%)，不同体温的患者之间的流感病毒检出率差异无统计学意义(P>0.05)。肌痛45例(50.00%)，头痛29例(39.20%)，乏力13例(50.00%)，咽痛40例(47.10%)，咳嗽60例(45.80%)。除头痛外，其他各种症状的患者流感检出率差异无统计学意义(P>0.05)。 结论流感冬春季节发病率较高，流感患者感染指标低于非流感患者。流感快速抗原检测敏感性较低，头痛有可能是比较有特异性的临床表现。

Clinical Analysis of 180 Patients with Influenza-like Illness

ObjectiveTo provide clinical evidence for diagnosis and treatment of influenza by analyzing the clinical characteristics of patient with influenza-likeillness admitted in the Emergency Department of Sun Yat-sen Memorial Hospital of Sun Yat-sen University from September 2018 to January 2019. Methods180 Cases of influenza-like symptoms were selected from September 2018 to January 2019 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University. The number of cases in different months was compared. According to the results of rapid antigen test of influenza, the patients were divided into influenza group and non-influenza group. The influenza group consisted of 90 patients with clinical diagnosis of influenza, including 31 males and 59 females, aged 15-94 years, with an average age of (36.82+ 16.43) years. According to the same sex-age ratio as the influenza group, 90 patients with influenza symptoms who did not meet the clinical diagnostic criteria were selected in the non-influenza group, including 32 males and 58 females, aged 17-89 years, with an average age of (37.35+ 15.59) years. There was no significant difference in sex-age ratio between the two groups. The blood routine white blood cell count, lymphocyte count, eosinophil count and clinical symptoms of the two groups were analyzed and compared, and the detection rate of influenza rapid antigen between various observation indicators was compared. ResultsThe incidence of influenza in December and January are higher than other months.The white blood cell and lymphocyte counts of the influenza group were significantly lower than those of the non-influenza group(6.71±2.40)×10⁹/Lvs(9.08±4.91)×10⁹/L, (0.97±0.49)×10⁹/L vs(1.29±0.75)×10⁹/L]; Among the common clinical symptoms, the positive rate of influenza rapid antigen assay was 13 cases of low fever (40.63%), 46 cases of moderate fever (54.76%) and 42 cases of high fever (56.00%). There was no significant difference in the detection rate of influenza virus among patients with different body temperature (P>0.05). There were 45 cases of myalgia (50%), 29 cases of headache (39.19%), 13 cases of fatigue (50%), 40 cases of pharyngalgia (47.06%) and 60 cases of cough (45.80%). There was no significant difference in the detection rate of influenza among patients with various symptoms otherthan headache (P>0.05). ConclusionThe incidence of influenza is high in winter and spring, the infection index of influenza are lower than that of non-influenza. The sensitivity of rapid antigen assay is low. Headache maybe a more specific clinical manifestation.