Department of Emergency, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai 201508, China.
Chin Med J (Engl). 2010 Feb 20;123(4):401-5.
From late May 2009, sporadic imported cases of novel influenza A (H1N1) were continuously confirmed in Shanghai, but there were few reports on its clinical presentation in China. The aim of the study was to investigate the demographic and clinical features of the laboratory-confirmed cases and the treatment with oseltamivir.
We performed a retrospective study in the Shanghai Public Health Clinical Center (SHAPHC), reviewing the medical records of the laboratory-confirmed patients derived from June 10 to July 20, 2009.
A total of 156 cases were enrolled, of whom 152 had a history of recent travel. The mean age was 22.6 years and 89 cases (57.1%) were males. The most common symptoms were fever, cough, and sore throat, with children more likely to run a temperature above 38.5 degrees C than adults. The mean leucocyte count was 5.4 x 10(9)/L, the mean neutrophil count 3.2 x 10(9)/L and the mean lymphocyte count 1.4 x 10(9)/L. Other findings included a normal range or elevated level of C-reactive protein (CRP) and glutamic-pyruvic transaminase and a normal or decreased level of prealbumin; the levels of prealbumin and CRP were significantly lower in the children than in the adults. Fifty-two patients had abnormal chest CT results, with small unilateral or bilateral pulmonary infiltrates, axillary and mediastinal lymphadenopathy and local pleural thickening, while no cases showed symptoms of hypoxia. All the patients received oseltamivir and recovered without complications, but the duration of fever and virus shedding were significantly longer in the children than in the adults.
Travel-related circulation may be an important reason for the H1N1 epidemic in the non-epidemic areas, and the virus caused mild respiratory symptoms. The infection in children was more severe in terms of prealbumin levels, temperature, the duration of fever and virus shedding. Oseltamivir was effective for H1N1, but more effective in the adults than in the children.
自 2009 年 5 月下旬以来，上海不断确诊散发的新型甲型 H1N1 流感输入病例，但国内有关其临床特征的报道较少。本研究旨在探讨实验室确诊病例的人口学和临床特征及奥司他韦治疗情况。
我们对 2009 年 6 月 10 日至 7 月 20 日在上海市公共卫生临床中心确诊的病例进行回顾性研究，查阅其病历资料。
共纳入 156 例患者，其中 152 例有近期旅行史。患者平均年龄为 22.6 岁，89 例（57.1%）为男性。最常见的症状是发热、咳嗽和咽痛，儿童体温高于 38.5℃者较成人多见。平均白细胞计数为 5.4×109/L，中性粒细胞计数为 3.2×109/L，淋巴细胞计数为 1.4×109/L。其他发现包括 C 反应蛋白（CRP）和谷丙转氨酶正常或升高，前白蛋白正常或降低；儿童的前白蛋白和 CRP 水平显著低于成人。52 例患者胸部 CT 异常，表现为单侧或双侧肺部小斑片状浸润影、腋窝和纵隔淋巴结肿大以及局部胸膜增厚，无低氧血症表现。所有患者均接受奥司他韦治疗，均痊愈且无并发症，但儿童发热和病毒排出时间较成人长。
旅行相关传播可能是非流行地区甲型 H1N1 流感流行的一个重要原因，病毒引起的呼吸道症状较轻。儿童感染时前白蛋白水平、体温、发热持续时间和病毒排出时间均较严重。奥司他韦对甲型 H1N1 流感有效，但对成人的疗效优于儿童。
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