2016年—2018年成都市某监测哨点医院127例确诊不同亚型流行性感冒住院患者临床特点对比分析  

A comparative analysis of clinical characteristics of 127 inpatients with different subtypes of influenza confirmed at a surveillance outpost hospital in Chengdu from 2016 to 2018

作　　者：向丽佳[1] 谷名琴[1] 解梅 郑兰[1] XIANG Lijia;GU Mingqin;XIE Mei;ZHENG Lan(Hospital Infection Control Department, Chengdu Second People's Hospital, Chengdu, Sichuan 610017, P. R. China;Department of Respiratory Medicine, Chengdu Second People's Hospital, Chengdu, Sichuan 610017, P. R. China)

机构地区：[1]成都市第二人民医院医院感染管理科,成都610017 [2]成都市第二人民医院呼吸科,成都610017

出　　处：《华西医学》2019年第3期295-298,共4页West China Medical Journal

摘　　要：目的比较不同亚型流行性感冒(流感)住院患者的临床特征,以利于临床医生早期识别。方法采用回顾性病例调查研究,使用2016年1月1日—2018年12月31日成都市某三级甲等哨点医院流感监测数据。对经核酸检测或病毒分离培养确诊为不同亚型流感病例的患者进行调查,分甲型H1N1、甲型H3N2、乙型Victoria(BV)系和乙型Yamagata(BY)系4种亚型进行临床特征、实验室检测指标及预后情况分析。结果共确诊127例流感病例。确诊流感患者中85.8%(109/127)白细胞计数降低或正常,78.8%(89/113)降钙素原水平升高。不同亚型确诊患者在年龄(P<0.001)、白细胞计数正常或低于正常值(P=0.041)、细菌/真菌/支原体/衣原体培养阳性(P=0.001)、肾损害(P=0.013)、出院结局(P<0.001)、住院费用(P=0.016)上比较,差异均有统计学意义。但各亚型患者在性别、临床表现、肝脏损害、心肌损害、住院天数上比较,差异均无统计学意义(P>0.05)。结论流感感染在部分患者可导致严重的临床并发症甚至死亡,甲型流感患者临床结局可能更为严重。流感患者具有降钙素原指标升高的实验室特征。Objective To compare the clinical characteristics of inpatients with different influenza subtypes, so as to identify the subtypes at an early stage. Methods A retrospective case study was conducted, using influenza surveillance data from January 1 st, 2016 to December 31 st, 2018 at a tertiary surveillance outpost hospital in Chengdu. Patients diagnosed with different subtypes of influenza by nucleic acid testing or virus isolation and culture were investigated, and their clinical characteristics, laboratory test results, and prognosis were analyzed and compared among the four subtypes including H1 N1, H3 N2, Victoria(BV), and Yamagata(BY). Results There were 127 inpatients with laboratoryconfirmed influenza. Among the confirmed influenza patients, 85.8%(109/127) had low or normal white blood cell counts, and 78.8%(89/113) had abnormally high procalcitonin levels. Among the patients with different subtypes,statistical differences existed in age(P0.001), low or normal white blood cell count(P=0.041), positive bacteria/fungus/mycoplasma/chlamydia culture(P=0.001), kidney damage(P=0.013), outcome at discharge(P0.001),and hospitalization expenses(P=0.016). However, there was no statistical difference in gender, clinical symptoms, liver damage, cardiac damage, or length of hospital stay(P0.05). Conclusion The infection of influenza can lead to severe clinical complications or even death. The outcomes of patients with influenza A may be more severe. An elevated procalcitonin level can be detected in quite a few patients with influenza.

关 键 词：流行性感冒 降钙素原 白细胞计数 监测 

分 类 号：R511.7[医药卫生—内科学] R181.8[医药卫生—临床医学]