流行性感冒的流行病学研究及临床分析

Epidemiological study and clinical analysis of influenza

目的:分析2014年～2017年西安地区儿童流行性感冒(简称流感)的流行特征及2017年流行性感冒的临床特点。方法:对2014年～2017年流行性感冒病例报告数据、病原学监测数据进行分析,并对2017年收治的80例流行性感冒病毒感染的患儿进行临床分析。结果:流行性感冒高发人群为5岁以下婴幼儿及儿童; 2014年～2017年分离到流行性感冒阳性毒株数分别为94株、32株、190株和132株,毒株类型以B型和A(H3NM2)型交替出现为主。2017年80例确诊为流行性感冒的患儿中,平均年龄(1. 5±1. 92)岁,20例(25. 0%)有基础疾病史,几乎所有患儿均出现发热和咳嗽症状,31例伴喘息(38. 8%),2例扁桃体上可见黄白色分泌物(2. 5%),流行性感冒确诊的平均时间为(6. 01±4. 11) d。53例(66. 3%)白细胞在正常范围内,WBC> 10×109/L者14例(17. 5%),中性粒细胞比例> 70%者5例(6. 3%); 18例(22. 5%)合并肺炎支原体感染,42例(52. 5%)伴支气管肺炎。均接受奥司他韦治疗,均治愈或好转出院。结论:在流行性感冒高发期不应将血象升高、中性粒细胞比例升高、扁桃体上有分泌物作为排除流行性感冒的指标。

Objective To understand the epidemiologic characters of influenza in Xi’an area from 2014 to 2017 and the clinical characteristics of pediatric patients who developed influenza in Children’s Hospital in Xi’an on 2017.Method Data were collected from pathogen surveillance and influenza outbreak report from 2014 to 2017.A descriptive study was done to analyze the clinical characteristics of 80 hospitalized children who was infected by influenza in 2017.Results The high-risk groups of influenza in Xi’an area were infants and children who under the age of 5.From 2014 to 2017,The positive influenza strains were respectively94,32,190 and 132,the types of strains were type B and type A(H3 NM2)appeared alternately.Among 80 pediatric patients with influenza virus in 2017,the average age was(1.5±1.92)years,20 cases(25.0%)had pre-existing medical conditions.Almost all cases had fever and cough,31 cases(38.8%)had wheeze,yellow and white discharges(2.5%)were seen on the tonsils in 2 cases,The average duration of flu diagnosis was(6.01±4.11)days.53 cases(66.25%)showed normal white blood cell(WBC).There were 14 cases(17.5%)with WBC >10×10^9/L and 5 cases(6.3%)with neutrophil counts >70%.18 cases(22.5%)attacked with mycoplasma,42 cases(52.5%)with bronchial pneumonia.All patients survived.All cases treated with oseltamivir.Conclusion Elevated blood counts,elevated neutrophil counts,secretions on the tonsils should not be used as indicators to exclude influenza in high incidence of flu.