临夏州147例住院甲型H1N1流感病例分析

目的 分析临夏回族自治州住院甲型H1N1流感病例,了解其区域性流行特点,为制定当地甲型H1N1流感预防的对策提供依据.方法 采用整群抽样的方法,收集2009年9月-2010年3月临夏回族自治州某甲型H1N1流感定点医院经实验室检查确诊的住院甲型H1N1流感患者病案,设计统一的调查表,对符合条件的147例病例进行流行病学及临床特征描述.结果 该地区甲型H1N1流感的主要发病人群为14～24岁的学生,发病时间集中在10～12月,全州各地均有发病.患者临床症状以咳嗽（98.64%）、乏力（88.44%）、咽痛（80.95%）、咽部充血（76.87%）、头痛（76.19%）及全身酸痛（53.06%）多见,咽痛和头痛发生率男性高于女性（89.32% vs 61.36%和89.32% vs 45.45%,均P＜0.01）;发病期间多有高热病史,男性总体发热发生率高于女性（70.06% vs 29.94%, P＜0.05）;实验室检查显示外周血淋巴细胞降低明显,男性患者的白细胞、淋巴细胞及中性粒细胞百分比异常率高于女性（P＜0.05）;患者经积极治疗后均预后良好.结论 该地区住院甲型H1N1流感患者外周血细胞分类男女间存在差异,男性总体发热发生率高于女性.应对该地区人群加强甲型H1N1流感预防措施教育,针对性地前移学生等人群疫苗的接种时间和和扩大接种范围,防止该病流行.

Case Study of 147 influenza A (H1N1) in-patients in the Linxia Hui Autonomous Prefecture

Objective By analyzing the hospital's medical records of influenza A (H1N1) patients in the Linxia Hui Autonomous Prefecture, to explore the epidemical characteristics of the disease and to provide evidences for the local prevention. Methods By cluster sampling, in-patients with influenza A (H1N1) diagnosed by laboratory experiment in the Linxia Hui Autonomous Prefecture between September 2009 and March 2010 were collected. Through unified questionnaire, 147 eligible patients were analyzed of epidemiology and clinical features. Results The high-risk group of the disease was mainly students aged 14-24 years, and to fall ill mainly from October to December in all over the Prefecture. The main clinical features were cough (98.64%), hypodynamia (88.44%), sore throat (80.95%), throat congest (76.87%), headache (76.19%), and body aches (53.06%). The incidences of sore throat and headache were significantly different between males and females (89.32% vs 61.36% and 89.32% vs 45.45%, P＜0.01). The diseases was companied with ardent fever. The incidence of fever was significantly different between males and females (70.06% vs 29.94%, P＜0.05). In additions, there was a obviously falling of the peripheral blood lymphocyte in the laboratory examination, and there were significantly higher rates of abnormal percentages of white blood cells, lymphocytes, and neutrophilic granulocytes in males (P＜0.05). The patients' conditions were improved after active treatment. Conclusion There were significant differences of distribution of peripheral blood cells between male and female influenza A (H1N1) patients. The incidence of fever was higher in males. It is necessary to strength the education of influenza A (H1N1) about the relative epidemic knowledge and to move forward  the inoculation period and to expand the inocuation range for the students, in order to prevent prevailing of the disease.