儿童与成人甲型H1N1流感临床对比分析

Clinical comparative study of Influenza A （ H1 N1 ） in children and adults

目的探讨儿童与成人甲型H1N1流感的临床特点，并进行对比分析。方法选择2009年9月～2010年1月间隔离治疗的甲型H1Nl流感患者57例，并将其分为成人组（23例）和儿童组（34例），比较两组患者的临床症状、合并症、实验室检查和特检等指标。结果成人组与儿童组甲型HlNl流感患者的扁桃体肿大、合并基础疾病等方面相近；成人组并发肺炎、呼吸衰竭等危重症的发生率较儿童组高，但无显著性差异（P〉0．05）。儿童组的高热、消化道症状发生率、表浅淋巴结肿大、支气管炎发生率较成人组明显增高，差异有显著性（P〈0．05或P〈0．01）。两组患者的外周血白细胞计数、乳酸脱氢酶、空腹血糖相近；成人组丙氨酸氨基转移酶、肌酸激酶及心电图异常等指标高于儿童组，但差异无显著性（P〉0．05）；成人组外周血淋巴细胞计数及低氯低钠血症异常指标明显高于儿童组，而儿童组x线异常率明显高于成人组（P〈0．05）；儿童组肌酸激酶同工酶明显高于成人组（P〈0．01）。结论甲型H1N1流感可引起多器官、多系统的病变损害，成人和儿童患者的临床表现不尽相同，各有其特点。

Objective To analyse the clinical features of Inlluenza A（ H1 N1 ） in children and adults. Methods 57 cases with Influenza A（ H1 N1 ） were selected from September 2009 to January 2010, and separated into adult group（23 cases） and children group （34 caseds） ;the groups in symptoms, complications, and laboratory examination, special examination and other indicators in two groups were com- pared and analyzed. Results Enlarged tonsils and the basis of disease are similar in adult and children groups;the incidence of complication with pneumonia, respiratory failure and critical diseases in adult was higher than in children group, but no statistical significance （ P 〉 0.05 ）. The incidence of high fever and gastrointestinal symptoms in children was higher than in adults （ P 〈 0.05 ） ; the incidence of superficial lymph node enlargement and bronchitis in children group was higher than in adult group, with significant difference（P 〈 0.01 ）. Peripheral blood white blood cell count, lactate dehydrogenase, fasting blood sugar disorders in children and adult groups were similar; alanine aminotransferase,creatine kinase and electrocardiographic abnormalities in adult group were higher than those of children group,without statistical significance （ P 〉 0.05 ） ; peripheral blood lymphocytes and abnormal low chlorine indicator of hyponatremia in adult group was significantly higher than children group, X ray abnormalities in children group was significantly higher than the adult group （ P 〈 0.05 ） ; abnormal creatine kinase MB index in children group was significantly higher than in adult group （ P 〈 0.01 ）. Conclusionlnfluenza A （ H1 N1 ） can cause multi-organ, multi-system damage, and adult and child performance in patients with different clinical performance, have their own characteristics.