成人社会获得性呼吸道流感病毒A感染临床观察

Clinical study on community-acquired adult respiratory tract infection of influenza virus A

目的 描述成人社会获得性呼吸道流感病毒A(INFA)感染的规律和特点。方法 对 80 4例成人急性呼吸道感染和 15 6名同期平行健康对照采用间接酶联免疫吸附试验测定血清INFA特异性IgM抗体。 结果 ( 1) 80 4例病人中 ,17 6%INFA -IgM抗体阳性 ,明显高于对照组 (P <0 0 1) ;3 1 3 %肺心病、2 3 3 %支气管炎、2 2 2 %支气管扩张、2 1 6%败血症、19 2 %哮喘加重、16 6%社会获得性肺炎、13 1%慢性阻塞性肺疾病 (COPD)急性加重、62 5 %急性心肌炎INFA -IgM阳性 ,分别非常显著高于对照组 (P均小于 0 0 1) ;15 0 %慢性肾功能不全 ,显著高于对照组 (P <0 0 5 )。 ( 2 ) 13 3例INFA -IgM抗体阳性中 ,48 1%有基础疾病 ;<3 6岁组 ,无基础疾病 ;3 6～ 65岁组 ,3 5 3～ 41 4%有基础疾病 ;66～ 75岁组 ,48 5 %有基础疾病 ;76～ 85岁组 ,68 8%有基础疾病 ;86岁以上组 ,10 0 %有基础疾病。 ( 3 ) 3年 2个月中 ,INFA -IgM抗体阳性结果主要集中在秋末、冬季和初春 ,其它季节散发。结论 ( 1)INFA是成人社会获得性呼吸道感染中重要的致病原 ;( 2 )部分气流限制性疾病、慢性左心功能不全急性加重与INFA感染有关 ;( 3 )INFA感染与基础疾病有关 ;( 4)

Objective To describe characteristics of adult respiratory tract influenza virus A (INFA)infection.Method 804 adult patients with acute respiratory tract infections were enrolled and 156 cases of healthy adults were concomitantly selected. Enzyme-linked immunoabsorbent assay was used to measure INFA serum specific IgM antibody.Result (1)In the total patients , 17.6% had positive INFA-IgM,significantly higher than the control(P<0.01);31.3% pulmonary heart disease,23.3% acute bronchitis,22.2% bronchiectasis,21.6% sepsis?19.2% asthma exacerbations,16.6% community-acquired pneumonia,13.1% exacerbations of chronic obstructive pulmonary disease as well as 62.5% acute myocarditis had positive INFA-IgM ,significantly higher than that of the control respectively(all P<0.01);15.0% chronic renal dysfunction had positive INFA-IgM,significantly higher than that of the control(P<0.05).(2)In the 133 cases with positive INFA-IgM antibody,48.1% had underlying disorders; the patients aged less than 36 years had no underlying disorders;in the patients aged 36～65 years,35.3～41.4% had underlying disorders;in the patients aged 66～75 years,48.5% underlying disorders,in the patients aged 76～85 years,68.8% underlying disorders,the patients aged more than 86 years,100% had underlying disorders.(3)During 38 months' observation,the cases with positive INFA-IgM antibody clustered in late fall,winter and early spring.Conclusion (1)INFA is an important pathogen for community-acquired adult respiratory tract infection.(2)Some airflow limitation diseases and exacerbations of chronic left ventricular dysfunction are related to INFA infection.(3)INFA infection is related to age as well as underlying disorders.(4)INFA infection are most likely to happen in fall,winter and spring.