儿童两种不同亚型甲流临床特征分析  

Analysis of clinical characteristics of two different subtypes of influenza A in children

作　　者：曾丽娥[1] 高培杰[2] 周文忠 黄新垦 ZENG Li'e;GAO Peijie;ZHOU Wenzhong;HUANG Xinken(Respiratory Department,Quanzhou Children's Hospital,Quanzhou 362000,Fujian,China;Department of Clinical Laboratory,Quanzhou Children's Hospital,Quanzhou 362000,Fujian,China;Department of Neonatology,Dehua County Hospital,Dehua 362500,Fujian,China)

机构地区：[1]福建省泉州市儿童医院呼吸科,福建泉州362000 [2]福建省泉州市儿童医院检验科,福建泉州362000 [3]福建省泉州市德化县医院新生儿科,福建德化362500

出　　处：《右江医学》2024年第8期700-706,共7页Chinese Youjiang Medical Journal

基　　金：泉州市科技计划项目(2022NS051)。

摘　　要：目的比较住院儿童不同亚型甲型流感(甲流)的临床特征,为临床诊疗和预防策略提供参考依据。方法统计2022年1月至2023年7月期间在泉州市儿童医院确诊为甲流的病例数量,并对住院患儿的临床资料进行了回顾性分析,比较不同亚型甲流的年龄分布、临床表现、实验室检查结果和临床结局。结果在符合甲流诊断标准的317例住院患儿中,甲型H1N1病例有209例(占65.9%),甲型H3N2病例有108例(占34.1%)。不同年龄段的患儿分布存在差异,其中2~6岁患儿数量最多,占总住院人数的53.3%。甲型H3N2患儿更易出现咳嗽、喘息、鼻塞/流涕和抽搐等症状,而甲型H1N1患儿则更易出现腹泻和呕吐,差异均有统计学意义(P<0.001)。在实验室检查方面,两种亚型流感之间比较差异无统计学意义(P>0.05)。甲型H3N2患儿入住重症监护室的比例较高,住院时间更长,并且并发肺炎/肺不张、流感相关性脑病、电解质紊乱的比例也较高,差异有统计学意义(P<0.05或0.001)。结论儿童不同亚型甲流的临床特征存在显著差异,在制订预防和治疗措施时,应充分考虑这些亚型的特定特征。Objective To compare the clinical characteristics of different subtypes of influenza A in hospitalized children,so as to provide reference for clinical diagnosis,treatment,and prevention strategies.Methods Statistical analysis was performed on the number of cases diagnosed with influenza A that met the diagnostic criteria in Quanzhou Children's Hospital from January 2022 to July 2023.Clinical data of hospitalized children were retrospectively analyzed to compare the age distribution,clinical manifestations,laboratory tests,and clinical outcomes of different subtypes.Results Among the 317 hospitalized children who met the diagnostic criteria for influenza A,209 cases(accounting for 65.9%)were identified as subtype H1N1 of influenza A,and 108 cases(accounting for 34.1%)were identified as subtype H3N2 of influenza A.There was a difference in the distribution of hospitalized children across different age groups,with the highest number of children aged 2 to 6 years old,accounting for 53.3%of the total hospitalized population.In terms of clinical manifestations,cough,wheezing,nasal congestion/runny nose,and convulsions were more commonly seen in the influenza A H3N2 group,while diarrhea and vomiting were more common in the influenza A H1N1 group,and differences were all statistically significant(P<0.001).There was no statistically significant difference in laboratory tests between the two subtypes of influenza(P>0.05).The influenza A H3N2 group had higher rate of admission to the intensive care unit,longer hospital stay,and higher rates of pneumonia/atelectasis,influenza-associated encephalopathy,and electrolyte imbalances,and difference was statistically significant(P<0.05 or 0.001).Conclusion There are significant differences in the clinical characteristics of different subtypes in children,and the specific characteristics of these subtypes should be taken into full consideration when implementing preventive and treatment measures.

关 键 词：流行性感冒 甲型H1N1病毒感染 甲型H3N2病毒感染 临床特征 

分 类 号：R725.6[医药卫生—儿科]