我国首例重症甲型H1N1流感病例流行病学调查分析  

An epidemiological survey of the first influenza A/H1N1 severe case in China

作　　者：李铁钢[1] 王玉林[1] 范建文[2] 张文芳[2] 伍业建[1] 许杨[1] 陆剑云[1] 柳洋[1] 王鸣[1] 

机构地区：[1]广州市疾病预防控制中心,广东510080 [2]广州市荔湾区疾病预防控制中心

出　　处：《中国预防医学杂志》2009年第10期887-889,共3页Chinese Preventive Medicine

摘　　要：目的通过对一例重症甲型H1N1流感病例调查分析,进一步探讨发病规律和流行特征,为预防和控制甲型H1N1流感提供依据。方法设计统一调查表,通过查阅病历和现场流行病学调查,描述疾病发生发展及传播过程,分析疫情流行病学特征。采集病例咽拭子,使用real-time RT-PCR方法检测甲型H1N1流感病毒核酸。结果病例于8月5日出现发热等呼吸道症状,6日继发呼吸、心跳骤停,同时伴有重症肺炎、缺血缺氧性脑病、病毒性心肌炎等并发症,临床诊断罹患布鲁格达综合征遗传疾病。家庭6名成员中5名甲型H1N1流感病毒核酸检测阳性。58名密切接触者经过7 d医学观察,未出现继发感染者。结论该病例为我国首例甲型H1N1流感重症病例,因甲型H1N1流感病毒感染出现高烧以及体内低钾诱发布鲁格达氏综合征,导致心脏骤停并引发一系列严重症状;病毒的传染力、致病力均较强;不能过度放松没有基础疾患年轻病例的诊治。Objective To find out the epidemiological pattern and characteristics of influenza A/H1 N1 by analyzing the first severe influenza A/H1 N1 case in China, and to further provide reference for formulating the prevention and control strategies. Methods Medical record and field investigation were used to describe the whole process of transmission of this case and illus- trate the onset and development of the disease. Throat swab collected from the case was used to test influenza A/H1 N1 viral nucleic acid by real-time RT - PCR. Results The ease developed fever and respiratory symptoms after his brother fell ill. The next day, he was sent to the hospital because of falling into a swoon complication with severe pneumonia, ischemic anoxic encephalopathy and viral myocarditis. This case was clinically diagnosed as suffering from Brugada syndrome, a rare inherited disease. Five of 6 people of the case＇s family were detected positive for influenza A/H1N1. No secondary cases were found among 58 close contacts during 7-day medical observation. Conclusion This patient has been proved to be the first severe case of influenza A （ H1 N1 ） in China .

关 键 词：甲型H1N1流感 重症病例 流行病学调查 

分 类 号：R511.7[医药卫生—内科学]