血液病患者感染甲型H1N1流感的预后分析  

The prognosis analysis of novel influenza A （ H1N1 ） in patients with hematologic disease

作　　者：高峥[1] 何雪峰 张日[3] 

机构地区：[1]苏州大学附属第一医院,215006 [2]江苏省血液研究所 [3]卫生部血栓与止血重点实验室

出　　处：《中华血液学杂志》2012年第2期113-116,共4页Chinese Journal of Hematology

摘　　要：目的探讨血液病患者与非血液病患者感染甲型H1N1流感病毒的临床特征和预后转归。方法收集2009年11月至2010年3月确诊的76例甲型H1N1流感患者临床资料，分析其中血液病患者与非血液病患者感染后的临床特征并采用回顾性多因素分析方法探讨临床特征和治疗转归的关系。结果76例患者中，重症46例，危重23例。所有患者均接受奥司他韦治疗。76例患者中血液病患者6例（重症2例、危重4例），4例（66．67％）死亡；非血液系统基础疾病患者70例，5例（7．14％）死亡。Logistic多因素分析表明，血液病基础、发病年龄均与死亡显著相关（P值分别为0．0008和0．0380），其中，血液病基础这一因素OR值为75．368（95％凹为5．980-949．853），而慢性肺部基础疾病、抗病毒药物介入时间、淋巴细胞计数与死亡无明显相关性（P〉0．05）。结论血液病患者感染甲型H1N1流感预后较差，病程进展快，病死率高。Objective To explore disease progression and prognosis factors of novel influenza A （H1N1） in immunocompromised patients with or without hematologic disease. Method A total of 76 con- firmed novel influenza A （ H1N1 ） infection patients from November 2009 to March 2010 included in the stud- y, their clinical feature was analyzed, and the relationship between clinical feature and outcome was explored retrospectively by multivariate analysis method. Results The whole 76 patients were administrated of oselta- mivir. Among the 76 patients, 46 were severe and 23 were critical. Of the 6 patients with immunocompro- mised hematologic disease, 2 were seveT＇e and 4 were critical, case-fatality rate was 66.67% （4/6）. The case-fatality rate of patients with non-hematologic disease was 10.42% （5/48）. Muhivariable logistic-regres- sion analysis showed that immunocompromised hematologic disease （ P = 0. 0008, odds ratio ： 75. 368 ; 95% CI, 5. 980 to 949. 853） and age （P =0. 0380） were independent risk factors for death. And other variables such as ehronical lung disease, interval time from the onset of illness and lymphocyte count had no statistical signigicance （P 〉 0.05 ）. Conclusions The novel influenza A （H1N1） patients with immunocompromised hematologic disease has a poor prognosis, they can deteriorate quickly and have high mortality, it may aid cli- nicians to pay high attention to these people.

关 键 词：流感病毒A型 血液病 预后 限定因素分析 

分 类 号：R55[医药卫生—血液循环系统疾病] R511.7[医药卫生—内科学]