34例甲型H1N1流感病例临床特征分析  

Clinical feature analysis of 34 cases of influenza H1N1 A

作　　者：邹永胜[1] 刘泽明[1] 黄永茂[1] 黄富礼[1] 史小玲[1] 陈庄[1] 

机构地区：[1]泸州医学院附属医院传染科,四川泸州646000

出　　处：《中国现代医学杂志》2011年第28期3532-3534,3537,共4页China Journal of Modern Medicine

摘　　要：目的研究34例甲型H1N1流感患者的临床特征。方法分析总结34例甲型H1N1流感患者的流行病学资料、临床表现、实验室检查、影像学资料以及治疗经过。结果患者年龄6～23岁,平均（15±4.56）岁。患者均为本市本土发病,有7例（20.59%）患者在起病前有短暂外地居住史。常见主要临床症状有发热34例（100%）,畏寒、寒战6例（17.65%）,全身乏力、酸痛10例（29.41%）,头晕、头痛8例（23.53%）,咽痛28（82.35%）,咳嗽18例（52.94%）。主要体征有咽部充血25例（73.53%）,扁桃体肿大13例（38.24%）,双肺啰音4例（11.76%）。实验室检查：外周血常规：WBC绝对计数大于正常值上限4例（11.76%）,低于正常值下限有9例（26.47%）。肝功检测仅2例（5.88%）谷丙转氨酶高于正常参考值（〉42 IU/L）,肾功均在正常范围内。本组病例入院时甲型H1N1流感病毒核酸检测（RT-PCR）均为阳性,入院后对患者进行动态甲型H1N1流感病毒核酸检测发现,转阴时间为入院后1天,最长的在出院后1周仍然发现甲型H1N1流感病毒核酸检测阳性。本组病例均予以痰热清和/或者抗病毒冲剂以及其他对症治疗,其中6例（17.65%）重症患者给予了奥司他韦。患者住院时间为3~8 d,中位数5 d。结论甲型H1N1流感是以发热为主要症状的呼吸道传染性疾病,本病治疗及时且无其他严重并发症时愈后良好,对临床症状轻无其他合并症的患者可不用奥司他韦抗病毒治疗,对重症患者可予奥司他韦治疗。【Objective】To study clinical features of 34 cases of A/H1N1 influenza.【Methods】To analyze and summarize the epidemiology data,clinical situation,laboratory examination,imageology data and therapy course of the patient of A/H1N1 influenza.【Results】The age from 6 to 23,average 15±4.5 years old,all of them were born in our city.There were 7 peoples who lived in other place for a short time before invasion.Common main clinical symptom is fever（34 cases,100%）,chilly,shiver（6 cases,20.59%）,all over the body debilitation,aching pain（10 cases,29.41%）,dizziness and headache（8 cases,23.53%）,pharyngodnia（28 cases,82.35%）,cough（18 cases,52.94%）.The main physical sign is pharyngeal portion congestion（25 cases,73.53%）,antiadoncus（13 cases,38.24%）,double lung dry rales and moist rales（4 cases,11.76%）.Laboratory examination： peripheral blood routine： the absolute counting of WBC just major top limit 4 cases（11.76%）,being lower than lower limits of normal 9 cases（26.47%）.Liver function detection only 2 cases（5.88%） ALT exceeded the normal reference value（42 IU/L）,the kidney function was within normal limits.This group case influenza viral nucleic acid detection（RT-PCR） was positive on admission,after admission,the dynamic state detection to the influenza viral nucleic acid discover that darkening time was 1 day and the longissimus was 7 days post discharge whose influenza viral nucleic acid detection（RT-PCR） is positive.All the cases were treated with sputamentum,heat schedule and/or antivirus powder preparation for infusion and other treat for sign,6 severe cases（17.65%） were treated with Oseltamivir Phosphate Capsules.The length of patient stay is 3 to 8 days,median is 5 days.【Conclusion】A/H1N1 influenza is a respiratory passage communicable diseases with the main sign of fever.The primary disease prognosis is good if we treat it in time and without other severity complication.There is no need to use Oseltamivir for those patients whose clinica

关 键 词：甲型H1N1流感 临床特征 治疗 

分 类 号：R512.99[医药卫生—内科学]