福建省127例新型甲型H1N1流感病例的临床特点分析  

Clinical features of 127 cases of novel influenza A （ H1 N1 ） infection in Fujian Province

作　　者：陈愉生[1] 翁恒 裴新亚[3] 林章树[1] 林挺岩[4] 林其昌[5] 洪旭初[6] 李鸿茹[1] 苗彦[1] 陈炆颖[1] 

机构地区：[1]福建医科大学福建省立临床学院呼吸科,福州350001 [2]福州肺科医院 [3]厦门市第一医院杏林分院 [4]福建医科大学附属协和医院 [5]福建医科大学附属第一医院 [6]福建省人民医院

出　　处：《中华结核和呼吸杂志》2010年第2期81-85,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的研究福建省127例治愈出院的新型甲型H1N1流感（简称甲型流感）病例的临床特点及预后。方法回顾总结福建省2009年5—7月临床及实验室确诊的127例甲型流感病例的临床资料，应用SPSS11．5统计分析，计数资料采用描述性分析，计量资料采用独立样本非参数检验。结果127例甲型流感病例中，男72例，女55例，均治愈。发病中位年龄为21岁（5个月至58岁），潜伏期1～12d。年龄≤5岁病例的临床症状持续时间为（8．2±4．1）d，较〉5岁病例的症状持续时间长[（5．4±3．0）d，z=3．182，P〈0．01]。本病临床症状主要为发热、咳嗽、咳痰及咽痛等流感样症状。中、高度发热组症状持续时间为（6．4±4．0）及（6．8±3．2）d，明显高于无发热组及低热组[（4．7±2．4）及（4．8±2．1）d，Hc=9．729，P〈0．05]。白细胞升高者症状持续时间为（8．5±4．2）d，明显高于白细胞低下及正常组[（6．3±4．7）及（5．4±2．8）d，Hc=4．729，P〉0．05]。淋巴细胞计数升高者症状持续时间为（6．8±3．3）d，明显长于正常组及淋巴细胞减少组[（5．2±3．2）及（5．4±3．4）d，Hc=10．105，P〈0．05]。6例X线胸片出现斑片状阴影，与X线胸片正常患者的症状持续时间比较无明显不同[（8．1±5．7）及（5．6±3．1）d，z=1．286，P〉0．05]。125例患者给予奥司他韦治疗，发病48h内用药的患者症状持续时间为（4．7±2．2）d，较发病48h后用药的患者症状持续时间[（7．4±4．1）d]明显缩短（z=4．907，P〈0．01），治疗效果佳，并发症少，预后良好。结论本组患者临床症状较轻，以上呼吸道感染症状为主，症状持续时间与年龄、发热程度及外周血白细胞计数密切相关，≤5岁、体温〉38℃、血白细胞和淋巴细胞计数升高者症状持续时间长；早期应用奥司他韦抗病毒治疗有助于缩短病程；本病病程Objective To investigate the clinical features of 127 cases of the novel influenza A/H1N1 infection in Fujian Province. Methods This study included 127 human cases with the novel influenza A/H1N1 infection in Fujian Province from May 2009 to July 2009. Data were collected and reviewed from hospital medical records. The statistical analyses were performed with SPSS 11.5. Results The median age of the 127 patients （55 were females） was 21 years （ range 0.4 - 58）. The median incubation period was 2 d （range 1 - 12 d）. The typical clinical symptoms included fever, cough, sputum, and sore throat. The duration of symptoms in patients less than 5 years old and in patients more than 5 years old were （8.2 ± 4.1 ） and （5.4 ± 3.0） d respectively, the difference between these 2 groups being significant （z = 3. 182,P 〈 0. 01 ）. There was also a statistically significant difference in the duration of symptoms between the high-temperature group and the low-temperature group [ （6. 8 ± 3.2） vs （4. 8 ± 2. 1 ） d, Hc = 9. 729, P 〈 0. 051. The duration of symptoms in the high, the normal and the low white blood cell groups were（6.3 ± 4.7） d, （5.4 ± 2.8） d, and （8.5 ± 4.2） d respectively, but the differences were not statistically significant （ Hc =4. 729 ,P =0. 094）. However, the duration of symptoms in the higher lymphocyte count group was significantly longer than that in the lower and normal lymphocyte count groups [（6.8 ± 3.3） vs （5.4 ± 3.4）, （5.2 ± 3.2） d, Hc=10.105,P〈0.01]. Chest radiography showed patchy infiltrates in 6 patients, and their duration of symptoms was longer than patients with normal chest radiography [ （8. 1 ± 5.7） vs （5.6 ± 3. 1 ） d], but the difference was not statistically significant （z = 1. 286,P 〉 0. 05）. 125 patients received antiviral treatment with oseltamivir and they all had a good prognosis. There was a statistical difference in the duration of symptoms between the patients who used osehamivir within 48 h afte

关 键 词：流感病毒A型 H1N1亚型 症状和体征 奥司他韦 

分 类 号：R511.7[医药卫生—内科学]