甲型H1N1流感非干预及应用奥司他韦治疗对照研究  

The comparison between non-antiviral and Oseltamivir treating in pandemic influenza A (H1N1) viral infection

作　　者：徐艳利[1] 陈志海[1] 肖江[1] 廖华[1] 闫杰[1] 胡居龙[1] 贾哲[1] 李晓光[1] 于芸[1] 李兴旺[1] 

机构地区：[1]北京地坛医院感染中心,100015

出　　处：《北京医学》2010年第3期176-179,共4页Beijing Medical Journal

基　　金：国家科技部支撑计划课题甲型H1N1流感联防联控应急科研项目<临床救治方案评价与病例资源集成研究>

摘　　要：目的研究甲型H1N1流感患者在非干预自然状态下的病情演变过程及预后,并与应用奥司他韦(达菲)治疗患者进行对照研究。方法对93例甲型H1N1流感确诊患者进行前瞻性临床观察,将入院时发病时间>48h的51例患者纳入不应用奥司他韦治疗的非干预组,将发病时间≤48h者的42例患者纳入奥司他韦组,比较两组患者的临床特征、症状持续时间、病毒转阴时间以及奥司他韦对患者病程的影响。结果两组患者临床表现较季节性流感轻,生化检查基本正常。非干预组发热持续时间为(4.16±3.04)d,病毒核酸转阴时间为(5.79±1.91)d;奥司他韦组发热持续时间为(2.53±1.46)d,病毒核酸转阴时间为(4.91±1.44)d;两组比较有显著性差异。结论甲型H1N1流感患者病情表现较为温和,流感样症状轻,轻症患者可呈自限性经过,可不予奥司他韦治疗,但隔离时间应适当延长至病后7d。Object To study the natural history of influenza A （H1N1） viral infection,and compare between natural history and Oseltamivir treating in group A （H1N1） viral infection Methods The prospective study was adopted to observe the clinical features of 93 patients with pandemic influenza A （H1N1） virus infection who were hospitalized in Beijing Ditan Hospital.Ninty-three patients were divided into two groups,51 patients trentment that was more than 48 hours after onset of illness were received the non-antiviral,42 patients that was within 48 hours after onset of illness were received Oseltamivir therapy.The clinical feature,the course of illness,prognosis,the time of symptom disappearing and RNA shedding,and the effect of Oseltamivir contributing the course of the illness were abserved.Results The symptoms of both groups patients were mild,and the examination results were general normal.However,the time of fever persistance in the non-antiviral group and antiviral group was（4.16±3.04）days and（2.53±1.46）days,According to rRT-PCR results,the time of RNA shedding in the non-antiviral group and antiviral group was（5.79±1.91）days and（4.91±1.44）days.There were significant differences between the two groups as to fever persistance and RNA shedding time （P〈0.05）.Conclusions The symptoms of the patients with the pandemic 2009 influenza A H1N1 virus infection were relatively mild,the course of disease in the mild patients presented natural limited,which may not be given Oseltamivir therapy.Nevertheless,the separated period needs to prolong to 7 days from onset of illness.

关 键 词：甲型H1N1流感 奥司他韦 自然病程 

分 类 号：R511.7[医药卫生—内科学]