【摘要】 目的 了解北京地區(qū)400例新型甲型H1N1流感患者的流行病學(xué)和臨床特征，總結(jié)規(guī)律，進(jìn)一步指導(dǎo)臨床診治。 方法 2009年5-12月期間，收治400例甲型H1N1流感確診病例，主要采用描述性流行病學(xué)方法對患者資料進(jìn)行回顧性分析，并運用單因素方差分析的方法對結(jié)果進(jìn)行檢驗。 結(jié)果 患者以青年和兒童人群為主，47.0%的患者有明確甲型H1N1流感接觸史，主要癥狀包括發(fā)熱（98.8%）、咳嗽（85.8%）、咽痛（58.5%）。咽部充血（94.0%）和扁桃體腫大（49.5%）為主要體征。外周血白細(xì)胞正?；蚱?，349例（82.3%）患者血清鐵降低，268例（72.6%）患者C反應(yīng)蛋白升高。在發(fā)病后不同時間內(nèi)給予奧司他韋治療的患者發(fā)熱持續(xù)時間和咽拭子的陰轉(zhuǎn)時間有顯著差異（P lt;0.001）。 結(jié)論 新型甲型H1N1流感發(fā)病多以青年和兒童人群為主，以流感樣癥狀為主，多數(shù)癥狀輕微，預(yù)后良好，C反應(yīng)蛋白和血清鐵的變化可能對于早期診斷有指導(dǎo)價值，奧司他韋早期抗病毒治療可以縮短病程。
【Abstract】 Objective To investigate the clinical and epidemiologic characteristics of pandemic influenza A (H1N1) virus infection in Beijing. Methods The epidemiological information and clinical characteristics of 400 patients with pandemic influenza A (H1N1) virus infection hospitalized in Beijing 302 Hospital from May to December, 2009 were analyzed retrospectively by descriptive epidemiology. One-way ANOVA was used to assess the results. Results H1N1 virus infection preferentially affected adolescents and young adults. The mean age of the patients was 23 years. A total of 189 (47.0%) of the patients had an identifiable epidemiologic link to another confirmed patient. The most common symptoms were fever (98.8%), cough (85.8%) and sore throat (58.5%). The main physical signs were pharyngeal portion congestion (94.0%) and antiadoncus (49.5%). The number of leukocytes in the peripheral blood was normal or low. The decreased serum iron and elevated C-reaction protein were found in 82.3% and 72.6% of the patients. There was significant difference in the duration of fever and viral shedding from throat swabs among the patients who accept the antiviral medication within the different time. Conclusion H1N1 virus infection preferentially affects adolescents and young adults, and presents with influenza-like illness. The clinical course of H1N1 virus infection is generally mild. The change of C-reaction protein and serum iron may be favorable for the diagnosis of H1N1. Early antiviral treatment may shorten the duration of fever and viral shedding.
引用本文： 謝楊新,姜天俊,聶為民,范榮,李文剛,張昕,閆慧穎,邱波,周志平,趙敏. 北京地區(qū)400例甲型H1N1流感患者流行病學(xué)及臨床分析. 華西醫(yī)學(xué), 2011, 26(1): 1-3. doi: 復(fù)制
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- 3. Monto AS. The risk of seasonal and pandemic influenza: prospects for control[J]. Clin Infect Dis, 2009, 48(Suppl 1): S20-S25.
- 4. Crum-Cianflone NF, Blair PJ, Faix D, et al. Clinical and epidemiologic characteristics of an outbreak of novel H1N1 (swine origin) influenza A virus among United States military beneficiaries[J]. Clin Infect Dis, 2009, 49(12): 1801-1810.
- 5. Jain S, Kamimoto L, Bramley AM, et al. Hospitalized Patients with 2009 H1N1 Influenza in the United States, April-June 2009[J]. N Engl J Med, 2009, 361(20): 1935-1944.
- 6. 姜天俊, 周先志, 趙敏, 等. 北京首批重癥急性呼吸綜合征患者臨床特征及預(yù)后分析[J]. 中華內(nèi)科雜志, 2003, 42(6): 369-372.
- 7. Wang JT, Sheng WH, Fang CT, et al. Clinical manifestations, laboratory findings, and treatment outcomes of SARS patients[J]. Emerg Infect Dis, 2004, 10(5): 818-824.
- 8. Chang HL, Chen KT, Lai SK, et al. Hematological and biochemical factors predicting SARS fatality in Taiwan[J]. J Formos Med Assoc, 2006, 105(6): 439-450.
- 9. Chiang CH, Shih JF, Su WJ, et al. Eight-month prospective study of 14 patients with hospital-acquired severe acute respiratory syndrome[J]. Mayo Clin Proc, 2004, 79(11): 1372-1379.
- 10. Jang TN, Yeh DY, Shen SH, et al. Severe acute respiratory syndrome in Taiwan: analysis of epidemiological characteristics in 29 cases[J]. J Infect, 2004, 48(1): 23-31.