深圳市龙华区甲型H1N1流行性感冒流行病学调查及特征研究

Epidemiological investigation and characteristics research of a H1N1 influenza in Longhua District of Shenzhen

目的了解深圳市龙华区甲型H1N1流行性感冒流行病学及临床特征,提高临床医师对该病的认识。方法对深圳市龙华区2016年5月～2017年3月确诊的甲型H1N1流行性感冒患者进行回顾性分析。结果本组患者156例,男95例,女61例,年龄16～72岁,平均年龄(49.8±1.5)岁,发病高峰期为2016年11～12月。临床上主要表现为流感症状,包括咳嗽、发热、鼻塞、头痛及全身酸痛等,咽部充血50例,咳嗽30例,发热89例,扁桃体肿大59例,咳痰15例等。91.45%患者外周血白细胞总数偏低或正常,63.78%患者中性粒细胞总数大于正常值,45.13%患者CD4^+T淋巴细胞低于正常下限水平。甲型H1N1流行性感冒患者的咽拭子标本在发热时检测为阳性,经胸部CT检查,患者表现为胸膜炎、肺炎、肺纹理增粗等;全部患者均痊愈出院。结论甲型H1N1流行性感冒传染性较强,其流行病学及临床特征与普通季节性流感相似,深圳市龙华区甲型H1N1流行性感冒患者以中年群体为主,病情较轻,轻型患者可无需奥司他韦抗病毒治疗,使用三九感冒灵、双黄连等中药制剂抗病毒治疗可以治愈。

Objective To understand the epidemiological and clinical characteristics of A H1N1 influenza in Longhua district of Shenzhen and to improve the understanding of clinicians. Methods Patients who were diagnosed as A H1N1 influenza Longhua district of Shenzhen from May 2016 to March 2017 were retrospectively analyzed. Results There were 156 patients in this study, including 95 males and 61 females aged 16 to 72 years old, with an average age of (49.8±1.5) years. The peak incidence period of the disease was from November 2016 to December 2016. The main clinical manifestations were flu symptoms, including cough, fever, nasal congestion, headache and body aches. There were 50 cases of pharyngeal congestion, 30 cases of cough, 89 cases of fever, 59 cases of antiadoncus and 15 cases of cough. The total number of peripheral blood leukocytes was low or normal in 91.45% patients, the total number of neutrophils was larger than normal value in 63.78% patients and the CD4^+ T lymphocytes of 45.13% patients were lower than the normal lower limit. The throat swab specimens of patients with A H1N1 influenza were tested positive during fever. After chest CT examination, the patients showed pleurisy, pneumonia, thickening of lung texture, etc. All patients were cured and discharged from hospital. Conclusion A H1N1 influenza is highly contagious and its epidemiology and clinical characteristics are similar to those of ordinary seasonal influenza. The patients with A H1N1 influenza in Longhua district of Shenzhen are mainly middle-aged groups and the condition is mild. Patients with mild A H1N1 influenza may not need treatment with oseltamivir. It can be cured by antiviral therapy of 999 Ganmaoling granules, double coptis and other traditional Chinese medicine preparations.