年轻人群甲型H1N1病毒感染临床特征与传播途径研究

Clinical features and transmission route of influenza A (H1N1) virus causing infection among young people

目的探讨年轻人群甲型H1N1病毒感染临床特征及可能传播途径。方法收集2009年10月-2010年1月医院就诊的18～35岁无基础疾病的67例甲型H1N1患者(H1N1组)临床资料,并对患者及其隔离居住环境进行连续采样,采用实时荧光定量PCR法检测甲型H1N1病毒,进而对两组患者临床特征及环境污染状况进行分析,同期37例季节性流感患者作为对照。结果甲型H1N1患者临床症状以咽痛、咽充血、咳嗽、头痛为主,发生率分别为71.6%、89.6%、77.6%、52.2%,其中咽充血在H1N1组患者多见而头痛在季节性流感患者中较多,差异有统计学意义(P<0.05);血常规指标以中性粒细胞升高、淋巴细胞减少、单核细胞升高和嗜酸性粒细胞减少多见,但与对照组相比,差异无统计学意义;连续对患者擦拭口鼻后的双手,病床枕边、桌面以及水杯或常触摸物品采样,均未检测出甲型H1N1病毒。结论观察的年轻人群甲型H1N1患者,临床症状以咽痛、咽充血、咳嗽为主,血常规指标与季节性流感,差异无统计学意义;日常生活接触传播在所观察的轻症年轻人群中,可能性较小。

OBJECTIVE To explore the clinical features and transmission routes of HIN1 influenza among young Chinese. METHODS From Oct 2009 to Jan 2010, totally 67 patients without underlying diseases aged from 18 to 35 years old were collected. The pharynx swab of the patients and the samples of isolation environments were detected by Real Time RT-PCR. The clinical features and environment contamination were analyzed. 37 patients with seasonal influenza were observed as control. RESULTS The main clinical symptoms of H1N1 influenza patients were pharyngalgia, pharynx congestion, cough, headache, antiadoncus, of which pharynx congestion was more common in HIN1 influenza patients than in seasonal influenza group （P〈0.05）. Elevated neutrophil and monocyte, lymphopenia, hypoeosinophilia were common, but there was no significant difference between the two groups. The environment samples of every patient collected from beds, pillows, tables, cups and their hands after touching their noses everyday from onset of the illness were not detected out H1N1 virus which suggested contact with contaminated surfaces played a little role in HIN1 transmission in the young group. CONCLUSION The main clinical symptoms of H1N1 influenza patients are pharyngalgia, pharynx congestion, cough, but there is no significant difference in routine blood tests between HIN1 and seasonal influenza group. The contact with contaminated surfaces plays a little role in H1N1 transmission in the observed mild young patients.