9例以肺炎为首发表现的人感染H7N9禽流感临床分析

Analysis of 9 Cases of Influenza A(H7N9) Infection with Initial Clinical Manifestation of Pneumonia

目的:分析广州市番禺区人感染H7N9禽流感病例临床特征,为早期诊治提供依据。方法:对每例H7N9禽流感确诊病例开展流行病学调查,收集临床资料,分析其发病特征。结果:9例人感染H7N9禽流感确诊病例,年龄46岁~81岁,均为男性,5例有基础疾病,6例患者有禽类暴露史,9例患者均无典型的流感样症状,影像学表现均为快速进展的肺炎,从起病到出现重症肺炎需要机械通气中位数时间为5天,从起病到抗病毒治疗中位数时间为6天。6例进展为ARDS或多器官功能衰竭死亡。结论:在流感高发季节,对于有禽类暴露史的肺炎患者,即使无明显流感样症状,应高度警惕禽流感肺炎的可能,及早给予抗病毒治疗和严重并发症的防治。。

Objective:To analyze clinical features of human infection with avian influenza A(H7N9)in PanYu District of Guangzhou,in order to provide scientific basis for early diagnosis and treatment.Methods:Epidemiological investigation were conducted for each confirmed case of H7N9 virus infection,and the clinical data were collected.The incidence characteristics were analyzed by descriptive method.Results:The age of the 9 confirmed cases was between 46 to 81 years,all were males,and 5 cases complicated with basic disease. 6 of 9 cases had poultry exposure history.All had no significant influenza-like illness as the initial sysptom,characterized by progressive pneumoniaand respiratory failure. The median times from the onset of illnessto mechanical ventilation were 5 days. The median time fromthe onset of illness to the initiation of antiviraltherapy was 6 days. Six cases eventually died of complicating with acute respiratory distress syndrome or multiple organ failures.Conclusion:During flu season,patients with a history of exposureto poultry should be given early antiviral therapy even though lack of influenza-like symptom.