221例甲型H1N1流行性感冒确诊病例临床特征

Clinical features of 221 patients with influenza A(H1N1)virus infection

目的:总结甲型H1N1流行性感冒的临床特征及治疗经验。方法:回顾分析海淀医院收治的221例甲型H1N1流感确诊病例的流行特点、临床特征及治疗效果。结果:所有患者均为北京市海淀区居民,且以在校学生为主。主要临床症状表现为发热97.7%、咳嗽81.0%、咳痰46.6%、咽痛47.5%,流涕24.4%。44.3%患者白细胞总数下降,28.5%患者C反应蛋白增高,10.0%患者肝功能异常,10.8%患者肌酸激酶和/或肌酸激酶同工酶增高。13.8%的患者合并支气管肺炎。221例甲型H1N1流感患者中,重症29例,危重症2例。53例患者口服奥司他韦抗病毒治疗。部分有合并症患者静点抗生素,治疗后均达到出院标准,平均住院4.8d。死亡2例,死于多脏器功能衰竭。结论:新型甲型H1N1流感大部分症状轻微、病程较短、疗效好;主要并发症为支气管肺炎。危重症患者可出现呼吸衰竭,甚至多脏器功能衰竭危及生命,应尽早给予抗病毒治疗。

Objective：To summarize the clinical characteristics and treatment experiences of 221 H1N1 influenza A cases.Methods：Epidemic factors,clinical features and treatment effectiveness were analyzed in 221 cases of HlNl influenza A hospitalized in Beijing Haidian Hospital.Results：All of the 221 cases lived in haidian district of Beijing,most of them were students.The main symptoms of H1N1 influenza were fever （97.7%）,cough（81.0%）,cough with sputum（46.6%）,sore throat（47.5%）and rhinorrhoea（24.4%）.In 28.5% of cases,C -reactive protein was elevated.Ten percent of the cases showed mild abnormality of liver function. 10.8% of the cases had little increase of creatine kinase （CK）or MB isoenzyme of CK and 10.4% cases had complication of pneumonia.Among them there were 29 serious illness and 2 critical illness.Fifty three cases were treated with oseltamivir,antibiotics were used in patients with complications.The average hospitalized time was 4.8 days.Two critical cases died for multiple organ dysfunction syndrome.Conclusion：The majority of H1N1 influenza A were characterized by mild symptoms,good prognosis and short period of hospitalization. Main complication was pneumonia.Critical patients had complications of respiration failure and multiple organ dysfunction syndrome.Oseltamivir should be used early.