儿童甲型和乙型流行性感冒早期血常规特征分析

目的分析儿童流行性感冒(流感)病例的临床特点,探讨血常规在甲型流行性感冒(甲流)、乙型流行性感冒(乙流)初期的临床应用价值,为临床诊疗提供依据。方法收集2018年12月-2019年4月西安交通大学第二附属医院儿科急诊在流感流行季节接诊的流感样病例,采集鼻/咽拭子应用流感病毒抗原检测试剂盒(胶体金法)进行抗原检测,同时对外周静脉血进行血细胞计数、形态分析,统计分析甲流、乙流与普通感冒的流行特征及不同年龄患儿血常规中不同细胞类型的特点。结果共收集流感样病例442例,依据流感胶体金法快速检测结果分为甲流187例,乙流60例,上呼吸道感染(上感)195例,3组一般资料比较差异无统计学意义(P>0.05)。甲流和乙流患儿以高热为主,而上呼吸道感染则以中等热度多见(χ~2=89.46,P<0.001);不同年龄组间上呼吸道感染患儿白细胞总数、血小板计数、中性粒细胞计数、淋巴细胞计数明显高于甲流和/或乙流患儿,6岁以下上呼吸道感染患儿单核细胞百分比较甲流患儿低,6~14岁的上呼吸道感染患儿单核细胞百分比较甲流和(或)乙流患儿低,婴幼儿流感患者体温越高单核细胞百分比越高,与中低热组差异统计学意义。结论与普通上感相比,流行性感冒患儿发热以高热为主。血细胞分类计数有助于鉴别流行性感冒与上感。

Early hematological characteristics analysis of children with influenza A and B

Objective To analyze the epidemiological characteristics of the children with influenza, and to explore the value of blood routine test in early diagnosis of influenza, so as to provide evidence for clinical diagnosis and treatment. Methods All the influenza-like cases from the Pediatric Emergency Department of the Second Affiliated Hospital of Xi'an Jiaotong University were enrolled in this study from December 2018 to April 2019.The antigen of influenza virus was detected according to the influenza virus antigen detection kit (colloidal gold method) in nasal or throat swabs and the blood cell count and morphological by peripheral venous blood.And the epidemic characteristics and the characteristics of different cell types in blood routines were analyzed and compared among children with the influenza A, B and acute upper respiratory infection at different ages. Results Totally 442 influenza-like cases were enrolled in this study, and were divide into influenza A group(n=187), influenza B group (n=60) and acute upper respiratory infection group(n=195).There were no significant differences on general data among the three groups.Children with influenza A and B most had high fever, while upper respiratory tract infections had moderate fever.The levels of white blood cell counts, platelet count, neutrophil count and lymphocyte count in children with acute upper respiratory tract infection were significantly higher than those in children with influenza A and/or B at the same age.The percentage of monocytes in children under 6 years old and with upper respiratory tract infection was lower than that of children with influenza A.For children aged 6 to 14 years, the percentage of monocytes in children with upper respiratory tract infection was significantly lower than that in children with influenza A and/or B at the same age.Furthermore, the higher the temperature, the higher the percentage of monocytes would be in children under 3 years old. Conclusions Children with influenza usually has a higher fever temperature than those with common upper respiratory infections.Differential blood cell counts can partially help distinguish influenza from common upper respiratory infections.