南昌市甲型H1N1流感病例死亡因素分析

Risk factors associated with fatality among severe cases of pandemic influenza H1N1 in Nanchang city

目的探讨重症甲型H1N1流感病例死亡因素。方法应用病例对照研究方法,以江西省南昌市2009-2010年甲型H1N1流感死亡病例9例为病例组,重症病例治愈者66例为对照组,应用SPSS 13.0软件进行统计分析。结果 2009-2010年南昌市甲型H1N1流感重症病例发生率8.33%,病死率为1%;慢性肝脏疾病、孕妇、有创吸氧在死亡组比例明显高于重症组,差异有统计学意义（分别OR=25.6,95%CI=1.97~333.55;OR=12.67,95%CI=0.86~186.91;OR=10,95%CI=1.07~93.44）;死亡组发生2种、≥3种并发症比例高于重症组,差异有统计学意义（分别OR=9.83,95%CI=1.17~82.94;OR=118,95%CI=8.72~1597）。结论慢性肝脏疾病、心血管疾病、孕妇等基础性疾病、有创吸氧、出现基础性疾病以外并发症可能是重症甲型H1N1流感病例死亡的危险因素,尽早发现以上病例,密切监控,调整治疗方案,降低病死率。

Objective To explore the risk factors associated with fatality among severe cases of pandemic influenza H1N1 in Nanchang city.Methods A case-control study was conducted with 9 cases of death and 66 severe cases of influenza H1N1 as controls.Results The ratio of the severe cases was 8.33% among all influenza A H1N1 patients.The mortality was 1%.The fatality of the cases with chronic liver disease,pregnancy,and invasive oxygen treatment was higher than that of severe cases with the odds ratio（OR）（95% confidence interval ） of 25.6（1.97-333.55）,12.67（0.86-186.91）,and 10（1.07-93.44）.Compared with the cases without complication,the fatality of the cases with 2 or 3 complications was higher with the OR（95%CI） of 9.83（1.17-82.94）and 118（8.72-1597）.Conclusion The basic diseases（chronic liver disease,cardiovascular disease,pregnancy）,with invasive oxygen treatment and complications are risk factors of fatallty for serere influenza A H1N1 patients.The case with the risk factors should be diagnosed earlier,monitored closely,and treated properly to reduce the fatality.