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日本 2009 年猪源甲型 H1N1 流感爆发的临床特征。

Clinical features of the 2009 swine-origin influenza A (H1N1) outbreak in Japan.

机构信息

Department of Internal Medicine, Kuramochi Hospital, 400-1 Yaita-machi, Utsunomiya, Tochigi 321-0112, Japan.

出版信息

J Infect Chemother. 2011 Jun;17(3):401-6. doi: 10.1007/s10156-010-0187-9. Epub 2010 Dec 21.

Abstract

To clarify the clinical symptoms of the influenza A virus during the 2009 pandemic influenza outbreak, we describe the clinical features of outpatients diagnosed with type A influenza by use of the rapid influenza diagnostic test (RIDT) from September to December 2009. Questionnaires were used to collect prospective data on 1,122 cases with influenza-like illness at our medical institutions. The independent predictors of influenza A virus were identified on the basis of demographic features and the clinical symptoms of the patients who tested positive for influenza A virus in the RIDT test. Of the 1,122 cases tested, 389 (34.7%) were positive for the influenza A virus. The median age of the influenza-positive patients was 14, and 58.9% of the patients were male. The symptoms fever, cough, rhinorrhea, and headache were statistically dominant. A history of recent contact with persons suffering from influenza or influenza-like illness at home, school, or in the workplace was significantly more common in the positive group than in the negative group. Pneumonia was observed in 2 (0.5%) of the positive patients, but the symptoms were only severe enough to require hospitalization in 1 of the 2. No deaths were observed among the 389 RIDT-positive patients. Although the spread of influenza A virus was both rapid and extensive, mainly among children under the age of 18, it seemed to be mild. Appropriate interpretation of the RIDT on the basis of recent clinical information, and early treatment with antiviral drugs might help to prevent severe illness from influenza pandemics in the future.

摘要

为了阐明 2009 年大流行流感期间甲型流感病毒的临床症状,我们描述了 2009 年 9 月至 12 月期间使用快速流感诊断检测(RIDT)诊断为甲型流感的门诊患者的临床特征。我们使用问卷前瞻性地收集了我们医疗机构中 1122 例流感样疾病患者的数据。根据患者的人口统计学特征和 RIDT 检测呈甲型流感病毒阳性的患者的临床症状,确定了甲型流感病毒的独立预测因子。在检测的 1122 例病例中,389 例(34.7%)对甲型流感病毒呈阳性。流感阳性患者的中位年龄为 14 岁,58.9%为男性。发热、咳嗽、流涕和头痛是统计学上占主导地位的症状。近期在家、学校或工作场所与流感或流感样疾病患者接触的病史在阳性组中明显比在阴性组中更常见。2 例(0.5%)阳性患者出现肺炎,但其中 1 例症状严重到需要住院治疗。在 389 例 RIDT 阳性患者中没有死亡病例。虽然甲型流感病毒的传播既迅速又广泛,主要发生在 18 岁以下的儿童中,但它似乎是温和的。根据最近的临床信息对 RIDT 进行适当的解释,并尽早使用抗病毒药物治疗,可能有助于预防未来流感大流行中的重症疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a808/7101646/ddd9072d4a46/10156_2010_187_Fig1_HTML.jpg

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