甲型H1N1流感病例临床分析

目的 分析甲型H1N1流感的流行和临床特点.方法 回顾性分析首都医科大学附属北京佑安医院2009年5至8月间收治的137例甲型H1N1流感病毒感染者的临床资料.结果 流行早期患者以输入性病例为主,主要来自美国、澳大利亚、加拿大,英国,后期为续发病例为主.发病年龄以儿童和青少年为主;临床主要表现为发热(108例)、咳嗽(93例)、咽部不适(67例).最常见的体征:咽充血(99例)和扁桃体肿大(46例).平均热程(3.3±1.5)d,症状消失时间平均(4.4±1.9)d.平均住院时间(5.5 ±2.1)d.实验室检查:39例(39.5%)外周血白细胞计数降低(3.3±0.4)×109/L,淋巴细胞百分比升高;甲型H1N1流感病毒核酸均阳性;胸部X线表现为肺纹理增强、模糊和肺炎表现.治疗:中药组、西药+中药组、对症或未用药组3组疗效对热程、症状消失时间、甲型H1N1流感病毒核酸转阴时间差异均无统计学意义.结论 甲型H1N1流感可为隐性感染和显性感染,传染性强、临床症状轻,临床过程多为自限性、轻症病例,类似季节性流感.

A clinical analysis of 137 cases of influenza A(H1N1)

Objective To analyze the epidemiolngy and clinical characteristics of influenza A ( H1N1 ). Methods A retrospective analysis was performed on the clinical data of 137 cases of influenza A (H1N1 ) admitted into our hospital during May to August 2009. Results In the early stage, most cases were imported from the US, Australia, Canada and the UK. While in the later stage, most of them were secondary. The patients were mainly children and youngsters. And the most common clinical manifestations were fever ( n = 108 ), cough ( n = 93 ) and sore throat ( n = 67 ) while the most common signs congestive throat (n=99) and swelling tonsil (n=46). The average fever period was 3.3 ± 1.5 days. The clinical symptoms vanished in 4. 4 ± 1.9 days. And the average length of stay was 5. 5 ± 2. 1 days. Laboratory tests:the count of leukocytes declined while that of lymphocytes increased in 39 cases ( 39.5% ). The test of influenza A (H1N1) nucleic acid was positive. The chest radiograph showed intensive pulmonary markings or patchy pneumonia-like signs. Treatments: the groups of patients using Chinese herbs, western medicine plus Chinese herbs, symptomatic relief and placebo showed no significant difference in fever period, recovery time and the negative-converting period of influenza A (H1N1) nucleic acid tests became negative.Conclusion Influenza A (H1N1) may be recessive or dominant. Despite a strong infectivity, the clinical symptoms are mild and the clinical course is self-limited, similar to the seasonal influenza.