上海最初10例新型甲型H1N1流感确诊病例临床特点

Clinical features of new influenza A(H1N1) 2009 in Shanghai:The first ten adult imported cases

目的探讨上海地区今年甲型H1N1流感确诊病例的临床特点。方法2009年5月24日～2009年6月15日上海市(复旦大学附属)公共卫生临床中心收治的甲型H1N1流感最初10例确诊病例的流行病学及临床资料。结果甲型H1N1流感病例的临床特点:①10例患者平均年龄为30.1岁(18～47岁);全部为输入性病例,感染地区为美国(70%),澳大利亚(30%)。②起病急、发病到住院时间平均为2.7天;潜伏期平均为4.3天;首发症状多为发热(70%),大多数为中低热、持续1～4天。主要症状和体征为发热(100%)、咳嗽(80%)、咽痛(50%),咽部充血(100%)和扁桃体肿大(50%)等,症状持续时间为1～7天。少数患者可出现病毒性肺炎(20%),无重症病例。③WBC多数正常,没有显著的中性粒细胞和淋巴细胞计数上升或下降;C反应蛋白升高和CD4+下降比较常见。④全部病例给予奥司他韦治疗,流感病毒转阴时间1～6天,中位时间4天。结论上海出现的甲型H1N1流感能在人与人之间传播,感染者大多表现出轻微的症状,很快痊愈。

Objective To summarize the epidemiology and clinical features of new 1 influenza A （ H1N1）, and to analyze characteristics of the first ten adult cases in Shanghai. Methods Retrospective analysis was conducted of epidemiology and clinical data of 10 cases with new influenza A （ H1 N1 ） From May 24 to June 15,2009. Results Clinical features of 10 cases of new influenza A （ H1N1 ） ：（1） Mean age was 30. 1 （ range 18 - 47 ） years; They were travellers from United States （70%） or Australia （30%） ; （2） Acute onset, They developed symptoms within a mean of 2.7 days of arrival in hospital, incubation period of 4.3 days （2 to 6 days） ; the first symptoms were fever （70%）, mostly in low-heat, last for 1 to 4 days. The main symptoms and signs were fever （100%）, cough （80%）, pharyngodynia （ 50% ）, pharyngeal hyperemia （ 100% ）, tansillar swelling （50%） ; a small number of patients might be with viral pneumonia （20%）, non-severe cases. （3） WBC were most normal, no significant neutrephil and lymphocyte count upward or downward, elevated serum C-reactive protein and decreased CD4 is more common;（4） Osehamivir in treatment was under the premise of H1 N1 negative patients from 1 to 6 days, with a median time of 4 days. Conclusion New Influenza A （ H1 N1 ） can spread from person to person. The prevalence of the infection period converse a wide range of flu symptoms. The patients recover quickly in Shanghai.