宁波地区成人及小儿重症甲型H1N1流感流行病学及临床诊治对比剖析.docVIP

宁波地区成人及小儿重症甲型H1N1流感流行病学及临床诊治对比剖析 　　 摘 要：目的：对比分析浙江省宁波地区成人及小儿重症甲型H1N1流感的流行病学和临床特征，为制定流感的防控策略和治疗方案提供科学依据。 方法：回顾性分析我院2009年7月1日-2009年12月31日收治的152例重症甲型H1N1流感患者的临床资料，其中成人组（≥14岁）92例，小儿组60例。结果：两组患者均以本地户籍者居多，均无明确甲型H1N1流感患者接触史。发热、咳嗽、咳痰为本病突出及特征性表现。重症患儿平均最高体温明显高于重症成人患者，出现流涕、消化道症状、咽部充血、呼吸衰竭、中性粒细胞异常率及LDH异常率等表现明显高于成人重症患者。胸部影像学检查小儿重症患者以支气管肺炎改变为主，成人重症患者则以肺炎改变为主。成人重症患者较多存在基础疾病，以肥胖及相关代谢综合征和妊娠为主，且成人重症患者平均住院时间长于小儿重症患者。相比轻症患者，重症患儿年龄更小，发热持续时间更长，LDH水平、中性粒细胞异常率以及胸部影像学异常率更高；重症成人患者年龄更大，发热体温峰值更高，发热持续时间更长，CK及LDH水平、WBC异常率、中性粒细胞异常率以及胸部影像学异常率更高，住院时间亦更长。所有患者均予以磷酸奥司他韦胶囊及痰热清针，均治愈出院。 结论：重症甲型H1N1流感病例仍以发热及呼吸道改变为主，并发症以支气管肺炎、肺炎、心肌损害及肝功能异常等为主，其表现及检验异常比较广泛，且成人及小儿患者临床表现不一致。中医药在甲型H1N1流感医疗救治和疫情防控中具有较好特色优势，值得推广。 　　 关键词：流感病毒A型，H1N1亚型；危重病；成人；儿童；临床分析 　　中图分类号：R373.13 文献标识码：B 文章编号：1673-7717(2012)01-0096-04 　　Comparative Analysis of Epidemiological and Clinical Characteristics in Adults 　　and Children with Severe Influenza A(H1N1) Virus Infection in Ningbo 　　JIANG Su?wen,HU Ai?rong,XUAN Wang?yi,LIANG Xiao?yue,ZHU De?dong,GAO Guo?sheng 　　(Ningbo No.2 Hospital, Ningbo 315016,Zhejiang,China) 　　Abstract:Objective:To comparatively analyze the epidemiological and clinical characteristics of adult and children patients with severe influenza A ( H1N1) virus infection in Ningbo, and to provide a scientific basis for further control and prevention strategies.Methods:The distribution of gender, age, region and clinical data were analyzed retrospectively from July 1, 2009 to December 31, 2009. Adult patients (more than or equal to 14 years old) were 92 cases and children patients were 60 cases.Results:Patients in the 2 groups were mainly Ningbo residences and hadnt contact history to influenza A ( H1N1). Fever, cough and expectoration were prominent and characteristic features of the disease. The average, the ratio of runny nose, gastrointestinal symptoms, throat congestion, respiratory failure, abnormal neutrophil and abnormal LDH in children were higher than adults. The changes of chest imaging were mainly bronchial pn