甲型H1N1流感确诊病例临床特点和治疗研究

Clinical characteristics and treatment report of 229 diagnosed H1N1 influenza cases

目的分析甲型H1N1流感确诊病例的临床特征,探讨治疗方法,为防治提供依据。方法对229例甲型H1N1流感确诊病例的一般情况,临床表现,实验室检查,胸部X线,治疗方法进行统计、分析。结果甲型H1N1流感确诊病例平均年龄18.12岁,男:女为3.09:1,临床症状、体征中前三位分别是咳嗽157例、咽痛135例、咳痰50例和发热228例、咽部充血225例。白细胞总数降低40例、中性粒细胞和淋巴细胞降低占多数。血清酶升高:ALT22例、AST29例、LDH26例、CK45例、CKMB8例,血脂降低:CHO83例、TG108例。胸部X线异常6例,单侧肺炎1例,双侧肺炎5例。中药使用率100%,达菲使用率35.80%,抗生素使用率16.59%,其它抗病毒药物使用率13.10%。平均住院5.21d。结论甲型H1N1流感确诊病例以咳嗽、咽痛、咳痰、发热、咽部充血和肺部病变居多,CT检出肺部病变多,绝大部分血白细胞降低,心肌和肝脏最易受侵害,药物治疗效果好,病程较短。

Objective To provide the basis of preventing and treating A H1N1 influenza by analysing the clinical characteristics of diagnosed mild cases and exploring the treatment method. Methods Gathering statistics and analysing the general conditions, clinical manifestations, laboratory tests, chest X - rays and treatment methods of 229 mild A H1N1 influenza cases. Results The average age of mild cases were 18.12. Male： Female = 3.09： 1. First three symptoms and signs were ： cough （ n = 157 ）, sore throat （ n = 135 ）, expectoration （ n = 50） , fever （ n = 228 ） and hyperemia of pharynx （ n = 225 ）. 45 cases had abnormal WBC, 5 cases were increased in WBC, 40 cases were decreased, 38 cases had neutrophilia, 74 cases had neutropenia, 50 cases had lymphocytosis and 59 cases had lymphocytopenia. The biochemical indexes ： ALT 22 cases, AST 29 cases, LDH 26 cases, CK 45 cases, CK - MB 8 cases, CHO 83 cases, TG 108 cases. 6 cases had abnormal chest X - rays with incidence of 2.62%. Single pneumonia（ n = 1 ） , double pneumonia （ n = 5）. The usage rate of TCM were 100% , Tamiflu （Osehamivir） were 35.80% , anti -bacteria 16.59% , other anti -virus drugs 13. 10%. Conclusion The main clinical manifestation of young and mild cases are cough, sore throat, expectoration, fever, hyperemia of pharynx and pulmonary changes. CT counted more for checking pulmonary changes. Most cases had a descent of WBC. Liver and heart were more tend to be influenced. Medicine had reliable cure effect.