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福建省127例新型甲型H1N1流感感染病例的临床特征

[Clinical features of 127 cases of novel influenza A (H1N1) infection in Fujian Province].

作者信息

Chen Yu-Sheng, Weng Heng, Pei Xin-Ya, Lin Zhang-Shu, Lin Ting-Yan, Lin Qi-Chang, Hong Xu-Chu, Li Hong-Ru, Miao Yan, Chen Wen-Ying

机构信息

Department of Respiratory Medicine, Fujian Provincial Medical College, Fujian Medical University, Fuzhou 350001, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2010 Feb;33(2):81-5.

Abstract

OBJECTIVE

to investigate the clinical features of 127 cases of the novel influenza A/H1N1 infection in Fujian Province.

METHODS

this study included 127 human cases with the novel influenza A/H1N1 infection in Fujian Province from May 2009 to July 2009. Data were collected and reviewed from hospital medical records. The statistical analyses were performed with SPSS 11.5.

RESULTS

the median age of the 127 patients (55 were females) was 21 years (range 0.4 - 58). The median incubation period was 2 d (range 1 - 12 d). The typical clinical symptoms included fever, cough, sputum, and sore throat. The duration of symptoms in patients less than 5 years old and in patients more than 5 years old were (8.2 +/- 4.1) and (5.4 +/- 3.0) d respectively, the difference between these 2 groups being significant (z = 3.182, P < 0.01). There was also a statistically significant difference in the duration of symptoms between the high-temperature group and the low-temperature group [(6.8 +/- 3.2) vs (4.8 +/- 2.1) d, Hc = 9.729, P < 0.05]. The duration of symptoms in the high, the normal and the low white blood cell groups were (6.3 +/- 4.7) d, (5.4 +/- 2.8) d, and (8.5 +/- 4.2) d respectively, but the differences were not statistically significant (Hc = 4.729, P = 0.094). However, the duration of symptoms in the higher lymphocyte count group was significantly longer than that in the lower and normal lymphocyte count groups [(6.8 +/- 3.3) vs (5.4 +/- 3.4), (5.2 +/- 3.2) d, Hc = 10.105, P < 0.01]. Chest radiography showed patchy infiltrates in 6 patients, and their duration of symptoms was longer than patients with normal chest radiography [(8.1 +/- 5.7) vs (5.6 +/- 3.1) d], but the difference was not statistically significant (z = 1.286, P > 0.05). 125 patients received antiviral treatment with oseltamivir and they all had a good prognosis. There was a statistical difference in the duration of symptoms between the patients who used oseltamivir within 48 h after disease onset and patients who used the drug beyond 48 h [(4.7 +/- 2.2) vs (7.4 +/- 4.1) days, z = 4.907, P < 0.01]. All of the patients survived.

CONCLUSIONS

the clinical symptoms of this series of patients with the novel influenza A (H1N1) infection appeared to be mild. There were several factors associated with longer duration of symptoms, including aged 5 years or younger, higher fever (body temperature > 38 degrees C), higher white blood cell count and lymphocyte count. The early use of anti-retroviral treatment with oseltamivir was useful in shortening the duration. The novel influenza A (H1N1) infection was a self-limited disease, and patients with no complications had a good prognosis.

摘要

目的

探讨福建省127例新型甲型H1N1流感感染病例的临床特征。

方法

本研究纳入了2009年5月至2009年7月福建省127例新型甲型H1N1流感感染病例。从医院病历中收集并回顾数据。采用SPSS 11.5进行统计分析。

结果

127例患者(55例为女性)的年龄中位数为21岁(范围0.4 - 58岁)。中位潜伏期为2天(范围1 - 12天)。典型临床症状包括发热、咳嗽、咳痰及咽痛。5岁以下患者和5岁以上患者的症状持续时间分别为(8.2±4.1)天和(5.4±3.0)天,两组间差异有统计学意义(z = 3.182,P < 0.01)。高温组和低温组的症状持续时间也有统计学差异[(6.8±3.2)天对(4.8±2.1)天,Hc = 9.729,P < 0.05]。白细胞计数高、正常和低的三组患者症状持续时间分别为(6.3±4.7)天、(5.4±2.8)天和(8.5±4.2)天,但差异无统计学意义(Hc = 4.729,P = 0.094)。然而,淋巴细胞计数较高组的症状持续时间显著长于淋巴细胞计数较低和正常组[(6.8±3.3)天对(5.4±3.4)天、(5.2±3.2)天,Hc = 10.105,P < 0.01]。胸部X线检查显示6例患者有片状浸润影,其症状持续时间长于胸部X线检查正常的患者[(8.1±5.7)天对(5.6±3.1)天],但差异无统计学意义(z = 1.286,P > 0.05)。125例患者接受了奥司他韦抗病毒治疗,预后均良好。疾病发作后48小时内使用奥司他韦的患者与48小时后使用该药的患者症状持续时间有统计学差异[(4.7±2.2)天对(7.4±4.1)天,z = 4.907,P < 0.01]。所有患者均存活。

结论

这一系列新型甲型H1N1流感感染患者的临床症状似乎较轻。有几个因素与症状持续时间较长有关,包括5岁及以下、高热(体温>38℃)、白细胞计数及淋巴细胞计数较高。早期使用奥司他韦进行抗逆转录病毒治疗有助于缩短病程。新型甲型H1N1流感感染是一种自限性疾病,无并发症的患者预后良好。

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