2013年广州市冬季人群流感样病例发病特点及临床处置效果分析

Epidemiological Features of Influenza-like Illness and Clinical Efficacy of Treatment in Winter of 2013 in Guangzhou

目的了解广州地区流感样病例及重症高危人群流行病学特征,初步评估临床诊疗效果,为早期识别、防控提供参考。方法回顾分析2013年12月—2014年3月广东省中医院发热门诊初诊符合流感样病例及重症高危人群,用Excel建立信息库,用SPSS 17.0统计软件进行统计分析。结果共收集流感样病例140例。流感病毒抗原检测阳性人数110例,其中男性65例(59.1%),女性45例(40.9%),平均年龄(30.37±18.08)岁。流感抗原阴性人数30例,其中男性20例(66.7%),女性10例(33.3%),平均年龄(26.85±23.42)岁。阴性组与活禽或流感患者接触史、血红蛋白均高于阳性组(P<0.05),咳嗽症状、血小板计数明显低于阳性组(P<0.01)。结论发病人群以青中年为主,男性居多,所有患者均有不同程度发热,多伴有咳嗽、头痛、肌肉酸痛、鼻塞流涕、咽痛等症状,少数患者伴有恶心呕吐、腹泻等消化道症状;咽拭子流感病毒抗原筛查阴性并不能排除流感可能性,对于重症高危人群,早期倍量使用抗病毒药物可能更佳。

Objectives To investigate the epidemiology of influenza-like illness in high-risk severe population, evaluate the preliminary clinical efficiency of treatment,and provide a basis for early recognition, prevention and control of the disease. Methods Collecting the data of severe influenza-like illness high-risk cases first visiting the fever clinics of Traditional Chinese Medical Hospital of Guangdong Province from December 2013 to March 2014. Medical database was established by Excel and SPSS was used for statistical analysis. Results The data on the influenza antigen of 140 influenza-like cases were collected, and the antigen was positive in 110 cases （65 males, average 30.37 ± 18.08 year-old）, and negative in 30 cases （20 male, average 26.85 ±23.42 year-old）. The history of contacting with live poultries or patients suffered from influenza and the content of hemoglobin in the antigen negative group were higher than those in the positive group （P 〈 0.05）, while the blood platelet count and cough in the antigen negative group （P 〈 0. 01 ） were lower than those in the positive group. Conclusions Majority of influenza-like cases were young males. All cases were characterized by having fever, usually accompanied with cough, headache, muscle and joint pain, runny nose and sore throat. A few of cases might have nausea and diarrhea. Negative influenza antigen screened by throat swabs could not exclude the possibility of influenza. Moreover, early use of anti-virus drugs in doubling dosage might have better results in high-risk severe cases.