甲型H1N1流感住院患者病毒核酸与淋巴细胞百分比的相关性分析

Analysis correlativity between viral nucleic acid and lymphocyte percentage on 191 hospitalized patient with pandemic influenza A

目的通过对2009年6月1日-2009年12月8日北京佑安医院收治的191例(死亡8例)甲型H1N1流感病毒感染确诊住院病例的分析,了解发病期间H1N1病毒感染患者H1N1病毒核酸及淋巴细胞百分比的变化趋势以及二者之间关系,以期为临床提供简单易掌握的诊断数据。方法用实时RT-PCR检测H1N1病毒核酸及血常规,并对191例患者的临床资料进行回顾性分析。结果 H1N1病毒感染患者的病毒核酸阳性率与淋巴细胞百分比呈强负相关性(r=-0.950,P<0.001);H1N1病毒感染且并发肺炎的患者H1N1病毒核酸为阴性时其淋巴细胞百分数大于病毒核酸阳性时的淋巴细胞百分数(42.96±2.50>31.63±3.03,P<0.01);在发病前7天,随着发病天数的增加,肺纹理清晰的患者淋巴细胞百分数有平滑上升趋势,而肺纹理增粗和肺炎的患者的淋巴细胞百分数上升趋势呈巨齿样波动;8例死亡病例死亡前的淋巴细胞百分比均低于20%,并在5%-15%范围内无规律波动。结论甲型H1N1病毒能引起淋巴细胞数量上的降低,患者淋巴细胞百分比的高低变化趋势在一定程度上预示病情的轻重,当淋巴细胞百分比持续小于20%,预示病情危重。

Objective To know correlativity between pandemic influenza A（H1N1）viral nucleic acid and lymphocytes percentage（lymph%）of 191 patients with H1N1 viral infection treatment in YouAn hospital on 1June-8December 2009 were useful to provide diagnosis data for doctors.Methods Specimens of H1N1 inpatients were tested by haemocyte counts and by real time RT-PCR（polymerase chain reaction）.The same time,191 case histories were analyzed retrospectively.Results A strong negative correlativity between positive percent of nucleic acid and the lymph % was certified along with onset time extension（r=-0.950,P〈0.001）.of the H1N1 viral infection patients complicated by pneumonia was higher than those with negative percent of viral nucleic acid（42.96±2.50 VS 31.63±3.03,P〈0.01）.Within 7days after onset,the lymph % of patients with clear pulmonary markings was elevation more smoothly than patients with pneumonia and thickness pulmonary markings.The lymph% of 8died patients were persistently less 20%and fluctuation scope was at 50-15%.Conclusion The lymphocyte amount of patients with H1N1 influenza virus infection were low resulting from invasion of H1N1 influenza virus.The change tendency of lymphocytes percentage indicated the patients＇ state of the illness.The less 20% persistently and the curve fluctuation of the lymph%imply that the pathogenetic condition was very severe.