103例甲型H1N1流感临床分析

目的:探讨2009年甲型H1N1流感的临床特点及预后。方法:回顾性分析2009年8月至2010年1月北京安贞医院98例甲型H1N1流感患者及5例外院会诊重症患者的临床资料。结果:本组病例中平均年龄(31.06±13.43)岁。主要临床表现为发热(100%)、咳嗽(88.3%)及畏寒(81.6%)等。重症及危重症患者中病死率为22.2%,并发症居前3位的是细菌感染、急性呼吸窘迫综合征(ARDS)、多脏器功能衰竭(MODS),其发生率分别为85.7%、57.1%及28.6%。慢性基础性疾病为重症及危重症病例发生的重要影响因素。结论:甲型H1N1流感以青壮年发病为主,主要临床表现为呼吸道症状,重症病例中多存在二重感染,并有可能存在凝血障碍,呼吸性碱中毒,低氧血症或Ⅰ型呼吸衰竭,且存在慢性基础性疾病更易发生。

Clinical analysis of 103 case of influenza A(H1N1)

Objective:To investigate the clinical features,diagnosis and prognosis of influencza A(H1N1) virus infection in 2009.Methods:The clinical data of 98 patients with influenza A(H1N1) admitted into Beijing Anzhen Hospital Affiliated to Capital Medical University and 5 critically ill patients with same diseases in other hospitals from August 2009 to January 2010 were retrospectively analyzed,and related literatures were reviewed.Results:In the group of cases,the average age was(31.06±13.43) years,and the main clinical manifestations presented fever(100%),cough(88.3%) and chill(81.6%),etc.The mortality rate of severe and critically ill patients was 22.2%.The most common complications was bacterial infection and acute respiratory distress syndrome as well as multively.Organ dysfunction syndrome,and the incidences was 85.7%,57.1% and 28.6%,respectively there was significant relation between chronic underlying diseases and presence of severe cases.Conclusion:The influenza A(H1N1) often occur in young adults,main clinical characteristics present respiratory tract symptoms.In severe cases,there may be double infection,coagulation disorder,respiratory alkalosis and hypoxemia or respiratory failure,which happen easily in existence of chronic underlying diseases.