甲型H1N1流感重症患者血象的动态变化及意义  

The Dynamic Changes and Significance of Blood Routine Examination in Severe Influenza A (H1N1) Patients

作　　者：张亚男[1] 付丽娟[1] 万媛[1] 

机构地区：[1]黑龙江省医院检验科,黑龙江哈尔滨150001

出　　处：《黑龙江医学》2012年第4期264-266,共3页Heilongjiang Medical Journal

摘　　要：目的通过对21例甲型H1N1流感重症患者的外周血液检测数据的研究,动态监测H1N1患者的血液指标变化,探讨其在疾病发生、发展转归中的临床意义。旨在初步探讨甲型H1N1患者血液学指标变化规律,为临床评估病情变化、指导治疗,提供帮助。方法本文收集黑龙江省医院2009-09～2011-01期间,确诊H1N1流感重症病例21例,对其外周血液指标进行检测分析。结果入院时,21例患者外周血白细胞计数为(4.09±2.61)×109/L,随后WBC渐升高,至治疗第3 d,90%的病例WBC计数恢复正常;入院时,淋巴细胞<0.8×109/L者占71.4%(15/21),计数为0.16～0.73×109/L,平均0.51×109/L;入院治疗3 d后,淋巴细胞计数至(0.58～2.94)×109/L,平均1.07×109/L,比率至0.13～0.47,均值为0.22;入院治疗6 d后,有86%患者淋巴细胞绝对数恢复正常。其中6例患者血小板下降,占28.6%。其他细胞分类及血红蛋白无明显异常。结论白细胞降低及淋巴细胞降低可视为H1N1重症感染的早期临床特征,白细胞及淋巴细胞的恢复,可作为判定疗效的参考指标;淋巴细胞的降低,显示H1N1病毒严重侵害患者免疫系统,淋巴细胞的转归正常,可作为监测患者免疫功能重建的指征。Objective 21 cases of severe influenza A（H1N1） patients with peripheral blood testing data were studied.To dynamic monitoring the changes of blood index,explore its clinical significance in the disease onset,development and outcome;To preliminary study the law of H1N1 patients′ hematological index changes,and provide help for the clinical assessment and treatment guide. Methods 21 confirmed cases of severe H1N1 influenza patients who were treated in Heilongjiang Provincial Hospital from September 2009 to January 2011,were observed.The peripheral blood indicators were detected. Results 21 cases of peripheral leukocytes on admission count（4.09±2.61）×109/L,followed by WBC gradually increased day and the WBC count in 90% cases returned to normal after the 3rd day;The cases who lymphocytes on admission less than 0.8×109/L in 71.4%（15/21）,count（0.16~0.73×109/L,average of 0.51×109/L）;and three days after hospitalization count（0.58~2.94）×109/L,average of 1.07×109/L,and the ratio（0.13 to 0.47,mean 0.22）;Six days later,86% lymphocytes absolute numbers returned to normal.Among them,Six cases of patients with platelet decline,accounting for 28.6%.The other cell sorting and hemoglobin was normal. Conclusion Leukopenia and lymphocytes decrease is the early clinical features of H1N1 severe infection.The recovery of white blood cells and lymphocytes can be used as to determine the effect of the reference index.Lymphocytes reduce shows that the H1N1 virus is serious aggressing the immune system.Lymphocytes turned normal indicate reconstruction of the immune function in patients.

关 键 词：甲型H1N1流感重症 外周血象 白细胞计数 淋巴细胞 血小板 

分 类 号：R448[医药卫生—诊断学]