老年甲型流感患者的临床特征及实验室检查指标

Clinical characteristics and laboratory examined indicators in the elderly patients with influenza A(H1N1)

目的分析老年甲型(H1N1)流感(简称甲流)患者临床特征,其血常规、血生化指标、炎症相关因子与普通感冒患者进行比较,明确其临床指导意义。方法收集2018年12月至2019年3月于我科住院的甲流患者(甲流组)及同期住院的普通感冒非甲流患者(对照组)共70例,其中甲流组及对照组各35例。比较2组患者血常规各项指标及血清白蛋白水平;同时比较甲流组患者治疗前后以上指标及白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、血清淀粉样蛋白A(SAA)的变化。应用SPSS 24.0统计软件进行分析。采用独立样本t检验对2组患者数据进行比较分析。结果甲流组治愈患者共32例,占91.4%;临床进展为危重型甲流伴肺炎导致死亡的共3例,占甲流患者的8.6%。相比于对照组,甲流组患者白细胞计数(P<0.05)、中性粒细胞绝对值及其百分比(P<0.01)均高于对照组,差异有统计学意义;而淋巴细胞绝对值及其百分比(P<0.01)、血清白蛋白水平(P<0.05)均明显低于对照组(P<0.05)。甲流组临床治愈的患者,治疗后较治疗前,淋巴细胞绝对值、淋巴细胞百分比均明显上升(P<0.01),IL-6、hs-CRP、SAA水平均明显下降(P<0.01),差异有统计学意义。结论老年甲流患者淋巴细胞及其百分比明显减低。淋巴细胞及其百分比、IL-6、hs-CR、SAA可作为疗效的观察指标。老年患者在积极治疗甲流同时亦应关注其营养状况。

Objective To analyze the clinical characteristics of the elderly patients with influenza A(H1N1),compare their findings in routine blood tests,serum albumin and inflammatory factors with the findings of patients catching cold,and determine their significance for clinical guidance.Methods A total of 70 patients(35 H1N1 patients;35 non-H1N1 patients as control group)were recruited in Department of Geriatrics of Xijing Hospital from December 2018 to March 2019.Findings in routine blood tests and serum albumin levels were compared between the two groups.A comparison was also made in the H1N1 group of the above indicators,interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)and serum amyloid A(SAA)before and after the treatment.SPSS statistics 24.0 was used for data analysis.t test was perfomed for data comparison between two groups.Results Of 35 patients with H1N1,32(91.4%)were cured,and 3(8.6%)died of severe H1N1 with pneumonia.Compared with the control group,white blood cell count(P<0.05)and absolute value of neutrophils and percentage(P<0.01)were much higher in the H1N1 group,and the difference was statistically significant,but absolute value of lymphocytes and the percentage(P<0.01)and serum albumin levels(P<0.05)were significantly lower.In the H1N1 patients clinically cured,absolute value of lymphocytes and the percentage increased significantly after treatment(P<0.01),and the levels of IL-6,hs-CRP and SAA decreased significantly(P<0.01).The difference was statistically significant.Conclusion Lymphocyte count and the percentage are significantly reduced in the elderly patients with H1N1.Lymphocytes and the percentage,IL-6,hs-CRP,and SAA can be used as indicators for therapeutic efficacy.On the treatment of H1N1,the nutritional status of the elderly patients should also be concerned.