139例儿童甲型流感的临床分析  

Clinical analysis on 139 children with influenza A

作　　者：叶建芬 刘明杰[1] 江极龙 YE Jianfen;LIU Mingjie;JIANG Jilong(Department of Pediatrics,Nanping First Hospital of Fujian Medical University,Nanping 353000,China)

机构地区：[1]福建医科大学附属南平市第一医院儿科

出　　处：《中国现代医生》2019年第21期62-65,69,共5页China Modern Doctor

摘　　要：目的探讨儿童甲型流感的临床特征及奥司他韦的疗效。方法回顾性分析本院儿科2016年3月~2018年2月收治的儿童甲型流感患者139例,对发病季节、年龄、临床症状、外周血白细胞计数及分类、CRP、奥司他韦疗效等进行分析。结果儿童甲型流感好发于1~2月及8月,以婴幼儿及学龄前儿童多见;临床症状以发热(97.2%)、咳嗽(69.7%)为主,热性惊厥发生率较高;病程早期(48 h内)外周血白细胞计数绝大多数正常(80.8%)或减低(17.2%),中性粒细胞比例增高(74.7%),淋巴细胞比例减低(84.8%),导致这样的比例改变主要是因为淋巴细胞计数不同程度的下降;CRP值绝大多数正常(83.5%)。结论提高对儿童甲型流感临床特点的认识,尤其是对早期血常规白细胞计数及分类改变的认识,有助于早期识别甲型流感患者并早期口服奥司他韦治疗,以达到缩短病程、提高治疗效果的目的。Objective To investigate the clinical characteristics of influenza A in children and the efficacy of oseltamivir.Methods 139 cases of children with influenza A who were admitted to the Department of Pediatrics in our Hospital from March 2016 to February 2018 were retrospectively analyzed.The disease onset season,age,clinical symptoms,peripheral blood leukocyte count and classification,CRP,oseltamivir efficacy were analyzed.Results Influenza A in children often occurred in January,February and August,and were more common in infants and preschool children.The clinical symptoms were mainly fever(97.2%) and cough (69.7%),and the incidence of febrile seizures was higher;in the early stage of the disease (within 48 hours),the peripheral blood leukocyte count was mostly normal (80.8%) or decreased (17.2%).The proportion of neutrophils was increased (74.7%),and the proportion of lymphocytes was reduced(84.8%).The reason for this proportional change was mainly due to the different degrees of decline in lymphocyte counts;the CRP value was mostly normal(83.5%).Conclusion The improvement of the understanding of the clinical characteristics of influenza A in children,especially the understanding of changes of white blood cell count and classification by early blood routine is helpful for early identification of patients with influenza A and early oral administration of oseltamivir,so as to reach the purpose of shortening the course of disease and improving the therapeutic effect.

关 键 词：甲型流感 儿童 临床特征 血常规 

分 类 号：R511.7[医药卫生—内科学]