现阶段甲型H1N1流感临床应答模式分析

A study of clinical response modes of H1N1 influenza A virus infection

目的通过对北京地坛医院收治的552例甲型H1N1流感筛查病例进行统计分析,探讨现阶段甲型H1N1流感临床应答模式的现状、取得的成绩及所遭遇的挑战。方法对来自于机场和发热门诊筛查的病例进行分组,比较两组病例一般情况、临床特点、住院时间、住院费用等资料进行详细统计分析。结果473例（85.7%）直接来自于机场甲型H1N1流感筛查病例,其中9例确诊为甲型H1N1流感病例（1.9%）;79例（14.3%）来自全市各医院发热门诊发现的甲型H1N1流感筛查病例,其中确诊5例（6.3%）,两组入院平均体温、体温恢复正常时间、具有流感样症状病例数、确诊病例数比较,差异均有统计学意义。确诊甲型H1N1流感病例平均住院时间为7.5（5.4-10.7）d,人均住院费用为1 252.3元;排除甲型H1N1流感病例平均住院时间为1.6（0.8-3.5）d,人均住院费用为548.6元。患者平均生活费为80元/d,医护人员每天使用一次性个人防护用品费用平均为185元/例患者,有大量相关人员参与了甲型H1N1流感筛查、隔离、转运、诊疗等工作。结论突发和重大传染病临床应答模式的建立还在不断探讨中,一套成熟且实用的临床应答模式的建立尚需不断实践和检验，在实践中及时调整方案，并为以后突发和重大传染病的防控提供依据，积累经验。

Objective To discuss the present situation, achievements and challenges of clinical response modes of H1 N1 influenza A virus infection by means of statistically analyzing clinical data of 552 patiens screened for HI NI influenza A virus infection hospitalized in Ditan Hospital, Beijing. Methods All of the patients with fever and screened for H1N1 influenza A virus infection in airports or fever-screening clinics were divided into 2 groups. The patients＇ clinical features, duration and expenses of hospitalization were compared and analyzed in details. Results In 473 patients （85.7%） with fever and screened for H1N1 influenza A virus infection from airports and 79 patients （ 14. 3% ） from fever-screening clinics, 9 （1.9%） and 5 patients （6. 3% ） were laboratory-confirmed as H1N1 influenza A virus infection, respectively. There were statistically significant differences in average temperature after admission, duration of fever, quantity of patients with flu-like symptoms and ratio of H1 N1 influenza A cases between two groups. The average duration of admission and expense of laboratory- confirmed H1N1 influenza A patients were 7.5 days （5.4-10.7 days） and 1 252.3 RMB yuan, while those of patients excluding H1N1 influenza A virus infection were 1.6 days （0. 8-3.5 days） and 548. 6 RMB yuan, respectively. Living expense for every patient provided by Chinese Government freely was 80 RMB yuan; and average expense of disposable sanitary protective articles of medical staff was 185 RMB yuan for every patient; and a lot of other medical staffs participated in screening, isola- ting, transporting, diagnosing and treating H1N1 influenza A virus infection. Conclusion The establishment of clinical response modes of sudden and severe infectious diseases is still being studied, and a mature clinical response mode still needs practicing, which will provide experience for diagnosis, treatment and prevention of sudden and severe infectious diseases in the future.