甲型H1N1流感患者实验室指标变化与临床的关系

目的 分析208例甲型H1N1流感患者实验室检测指标，探讨其变化特点对甲型H1N1流感诊断及评估病情发展变化的价值。 方法 在病程中进行血常规、肝、肾功能指标、T淋巴细胞亚群以及其他感染性实验室指标的检测。对检验结果进行回顾性总结和统计学分析。 结果 入院初期绝大多数患者红细胞、血小板计数在正常范围内；43.3%患者白细胞总数下降，有36.1%患者中性粒细胞和16.8%患者淋巴细胞数降低；入院初期绝大多数患者肝、肾功能生化指标正常，部分患者存在电解质紊乱；CD3+、CD4+、CD8+T淋巴细胞数下降比较显著，特别是重症患者，并在入院数天后降至极低值，又随病情好转而回升正常。 结论 CD3+、CD4+、CD8+T淋巴细胞及血常规检查的淋巴细胞计数，是甲型H1N1流感患者早期鉴别诊断以及病情严重程度的重要指标，动态观察其变化对患者的病情发展、疗效观察及预后判断等方面有重要的指导价值。

Relationship between laboratory and clinical indicators in patients with influenza A H1N1

Objective To analysis the laboratory indicators of 208 cases with influenza A H1N1 and explore the characteristics and the value of laboratory indicators for the diagnosis and progression of the disease. Method The function of liver and kidney, T lymphocyte subsets and other laboratory indicators were detected in the course of disease. The backward summary and statistics analysis were performed. Results In the early stage, the counts of red blood cell and platelet in most patients were within the normal range. The counts of white blood cell in 43.3% of the patients decreased. The counts of neutrophils decreased in 36.1% and lymphocytes in 16.8% of the patients. The functions of liver and kidney in majority of patients were normal, and some of the patients showed electrolyte imbalance. CD3+, CD4+, CD8+ T lymphocytes significantly decreased, especially in critical patients. CD3+, CD4+, CD8+ T lymphocytes were extremely low in a few days after admission and recovery period with the improved condition. Conclusion The count of CD3+, CD4+, CD8+ T lymphocytes and peripheral blood lymphocytes should be the important indicators for early diagnosis and disease severity of influenza A H1N1 and have guiding value for progression and evaluation for curative efficiency and prognosis to dynamically observe the changes of the disease in the patients with H1N1 influenza.