奥司他韦治疗群体性成人甲型H3N2流感

Analysis of mass H3N2 influenza in adult patients treated by oseltamivir

目的分析驻闽部队群体性成人甲型H3N2流感的发病特点，并观察奥司他韦治疗的疗效和不良反应。方法对2014年夏季驻闽部队作训期间有流感症状并初筛显示为甲／乙型流感阳性的官兵进行问卷调查，并采用咽拭子病毒核酸检测（RT．PCR）进行诊断。予奥司他韦75mg，po，bid，疗程2～5d。观察患者症状、体征、实验室指标的改变，评估治疗效果，记录不良反应发生情况。结果2014年6月24日至7月21日共纳入85例，均确诊为甲型H3N2流感。患者年龄（22．2±4．6）岁，主要临床表现为发热、咳嗽、咳痰、全身酸痛、咽痛、乏力、头痛等流感样症状。实验室检查表现为淋巴细胞计数减少、C反应蛋白升高。经奥司他韦治疗后，均治愈，患者体温降至正常时间为（2．0±0．4）d。32例（38％）患者发生不良反应，发生率排前3位的为白细胞减少、粒细胞减少、窦性心律不齐。结论本次部队群体性甲型H3N2流感属季节性流感，传染性强，传播速度快，病情相对轻。奥司他韦疗效好，不良反应发生率高于以往报道，最主要表现为白细胞和粒细胞减少。

AIM To study clinical characteristics of H3N2 influenza outbreak among soldiers in Fujian province, and observe the effects and adverse reactions of oseltamivir. METHODS Questionnaire surveys were taken to collect clinical data of H3N2 influenza soldiers outbreak in Fujian province during the Summer of 2014. The patients who had flu symptoms and were primary diagnosis with A/B influenza by primary screen have been confirmed by RT-PCR method. Osehamivir was used to treat these patients （75 mg, po, twice a day for 2-5 days）. Variation of body temperature and laboratory indexes were observed, and therapeutic effect and adversereactions were evaluated. RESULTS Totally 85 patients diagnosed with H3N2 influenza have been enrolled in this study from June 24, 2014 to July 21, 2014. The average age of these patients was （22.2±4.6） year. Main clinical manifestations of these patients included fever, cough, sputum, body aches, sore throat, fatigue, headaches and other flu-like symptoms. Decrease of lymphocyte count and increase of C-reactive protein were main laboratory manifestations. All patients have been cured. Duration of body temperature drop to normal was （2.0 ± 0.4） d. The incidence of adverse reactions was 38% （32/85）. The top three adverse reactions of this study were leucopenia, granuloeytopenia, and sinus arrhythmia. CONCLUSION This H3N2 flu outbreak was a seasonal flu which was highly infective, transmitted quickly and flu symptoms were relatively slight. Therapy with oseltamivir had good effect with relatively high incidence of adverse reactions. The main adverse reactions were white leucopenia and granuloeytopenia.