新疆甲型H1N1流行性感冒住院患者临床特征及并发心肌损害分析  

Analyses of clinical characteristics and myocardial damage among patients with H1N1 influenza in Xinjiang

作　　者：孙晓风[1] 买买提艾力·吾布力[1] 刘浩[1] 依巴古力[1] 李雯莉[1] 李琴[1] 贾晓焕[1] 张跃新[1] 

机构地区：[1]新疆医科大学第一附属医院感染性疾病科,乌鲁木齐830054

出　　处：《中华传染病杂志》2011年第6期357-360,共4页Chinese Journal of Infectious Diseases

基　　金：新疆维吾尔自治区心血管病研究重点实验室开放课题项目（XJDX0903-200904）;新疆维吾尔自治区重点学科（内科学）建设基金资助项目（XJDX0903-2009-04）

摘　　要：目的探讨新疆甲型H1N1流行性感冒（流感）流行期间住院患者临床特征及心肌损害的特点。方法回顾性收集2009年8月至2010年1月新疆医科大学第一附属医院和新疆各地收治的确诊为甲型H1N1流感病例的资料。计量资料采用t检验，计数资料用卡方检验。结果258例甲型H1N1流感患者中，普通型164例，重症型94例，其临床特点以发热、咳嗽、咳痰、全身肌肉关节酸痛、咽痛等为主。94例重症型表现为高热、呼吸困难、紫绀、低氧血症、双侧肺炎等，死亡22例，病死率为23．4％；主要死因为呼吸衰竭并多器官功能衰竭或心功能衰竭。76％患者伴有各种慢性疾病，15例妊娠者中有12例发展为重症型。与普通型比较，有基础疾病的患者病情重，重症型患者心电图、血WBC、血糖、AST、肌酸激酶、肌酸激酶同工酶MB、a羟丁酸脱氢酶和乳酸脱氢酶等异常比例高，重症患者CD4＋／CD8＋T淋巴细胞比值更低（1．23±0．56比0．99±0．53，t=3．543，P=0．039）。结论新疆甲型H1N1流感重症型患者原有慢性疾病、妊娠、心肌酶与心电图同时异常和CD4＋／CD8＋T淋巴细胞比值降低者所占比例更多。Objective To explore the clinical characteristics and myocardial damage of the influenza A （H1N1） cases in Xinjiang. Methods Informations related to the influenza A （H1N1） cases were respectively collected from hospitalized cases in Xinjiang region. Measurement data were analyzed using t test and enumeration data were analyzed using chi square test. Results A total of 258 patients with influenza A （H1N1） were reported from Aug. 2009 to Jan. 2010, including 164 cases of common type and 94 of severe type. The main symptoms of the patients included high fever, cough, expectoration, angina and sore throat. Severe cases presented with high fever, dyspnea, cyanosis, hypoxemia and bilateral pneumonia. Twenty-two cases died of severe form with mortality rate of 23.4%（22/94）. The main causes of death were respiratory failure complicated with multiple organ failure or heart failure. Among severe cases, 76% had underlying chronic diseases and 12 out of 15 pregnant cases developed severe type. Compared with common type cases, more severe cases had underlying diseases and the abnormal rates of electrocardiogram （ECG）, blood leukocyte counts, blood glucose, aspertate aminotransferase （ AST）, creatine kinase （ CK）, CK MB, α-hydroxybutyrate dehydrogenase （α-HBDH） and lactic dehydrogenase （LDH） were higher; while the ratio of CD4＋/ CD8＋T lymphocytes was much lower （1. 23±0. 56 vs 0. 99±0. 53; t=3. 543, P=0.039）. Conclusions Among sever cases with influenza A （H1N1） in Xinjiang, the proportion of cases with underlying diseases, pregnancy, abnormal myocardial enzymes and ECG, lower CD4＋/CD8＋ ratio are relatively high.

关 键 词：流感 人 流感病毒A型 H1N1亚型 慢性病 妊娠 肌酸激酶 心电描记术 CD4 阳性T淋巴细胞 CD8阳性T淋巴细胞 

分 类 号：R511.7[医药卫生—内科学]