Mu Yong-ping, Zhang Zhi-yong, Xi Xiu-hong, Lu Hong-zhou
The Clinical Center for Public Health of Shanghai affiliated to the Fudan University, Shanghai, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2010 Oct;44(10):878-83.
Analyze the clinical characteristics of the mild cases of pandemic influenza H1N1 virus infection, as well as the relationship of clinical characteristics and patient genders.
A total of 245 influenza A (H1N1) patients confirmed by viral nucleic acid detection were included in the study. The patients' personal information, signs and symptoms, lab and iconography data, disease course, negative seroconversion duration of new influenza A (H1N1) viral nucleic acid after antiviral treatment and hospitalization stay were analyzed. Measurement data were analyzed using one-way analysis of variance (ANOVA) by software SPSS 11.5. P < 0.05 was defined as statistically significant.
(1) Among the 245 patients, 130 were males and 115 were females, yielding a sex ratio of 1.13:1. Almost 52.0% (127/245) of the patients came from Australia, and 64.5% (158/245) were between 18 and 40 years old. (2) Clinical manifestations included fever (98.4%, 241/245), cough (80.8%, 198/245) and throat congestion (95.9%, 235/245), and lab findings were characterized by elevated C-reaction protein (CRP, 71.0%, 174/245) and neutrophil (52.2%, 128/245). (3) Female patients had significantly lower serum Prealbumin (pre-A) levels than male patients [(245.04 ± 75.3) vs (273.34 ± 92.18) mg/L, F = 5.55, P = 0.019]. (4) The patients' serum CRF levels significantly decreased after the treatment [(4.06 ± 3.47) vs (14.54 ± 14.68) mg/L, F = 6.18, P = 0.016], while the levels of CD3, CD4 and CD8 were significantly increased after treatment [(1451.23 ± 443.97) vs (819.97 ± 375.75) cell/µl, F = 32.61, P = 0.000; (771.33 ± 251.92) vs (435.36 ± 215.35) cell/µl, F = 44.43, P = 0.000; (593.16 ± 237.19) vs (342.47 ± 180.12) cell/µl, F = 28.518, P = 0.000, respectively]. (5) Approximately 30.6% (75/245) of the patients had abnormal signs on chest CT iconography, and 22.0% (54/245) had obvious signs indicating pneumonia. The average disease course was (3.9 ± 1.2) days, the average hospitalization stay was (5.0 ± 1.4) days, and the negative seroconversion duration of the mRNA after antiviral treatment was (3.8 ± 1.4) days.
The influenza A (H1N1) virus was characterized by fever, cough and throat congestion, with elevated CRP and neutrophil being the most significant lab findings. The influenza A (H1N1) strain was able to affect multiple organs, including being able to affect hepatic synthesis of pre-A as well as immune functioning. The influenza A (H1N1) influenza virus strain was mild clinically, with short disease course and good prognosis.
分析甲型H1N1流感大流行轻症病例的临床特征,以及临床特征与患者性别的关系。
本研究纳入245例经病毒核酸检测确诊的甲型H1N1流感患者。分析患者的个人信息、体征和症状、实验室及影像学数据、病程、抗病毒治疗后新型甲型H1N1流感病毒核酸血清学阴转持续时间及住院时间。计量资料采用SPSS 11.5软件进行单因素方差分析。P<0.05为差异有统计学意义。
(1)245例患者中,男性130例,女性115例,性别比为1.13:1。近52.0%(127/245)的患者来自澳大利亚,64.5%(158/245)的患者年龄在18至40岁之间。(2)临床表现包括发热(98.4%,241/245)、咳嗽(80.8%,198/245)和咽喉充血(95.9%,235/245),实验室检查结果以C反应蛋白(CRP)升高(71.0%,174/245)和中性粒细胞升高(52.2%,128/245)为特征。(3)女性患者血清前白蛋白(pre-A)水平显著低于男性患者[(245.04±75.3)vs(273.34±92.18)mg/L,F=5.55,P=0.019]。(4)治疗后患者血清肌酐清除率(CRF)水平显著下降[(4.06±3.47)vs(14.54±14.68)mg/L,F=6.18,P=0.016],而CD3、CD4和CD8水平治疗后显著升高[(1451.23±443.97)vs(819.97±375.75)细胞/µl,F=32.61,P=0.000;(771.33±251.92)vs(435.36±215.35)细胞/µl,F=44.43,P=0.000;(593.16±237.19)vs(342.47±180.12)细胞/µl,F=28.518,P=0.000]。(5)约30.6%(75/245)的患者胸部CT影像学有异常表现,22.0%(54/245)有明显的肺炎表现。平均病程为(3.9±1.2)天,平均住院时间为(5.0±1.4)天,抗病毒治疗后mRNA血清学阴转持续时间为(3.8±1.4)天。
甲型H1N1流感病毒以发热、咳嗽和咽喉充血为特征,CRP和中性粒细胞升高是最显著的实验室检查结果。甲型H1N1毒株能够影响多个器官,包括影响肝脏前白蛋白的合成以及免疫功能。甲型H1N1流感病毒株临床症状较轻,病程短,预后良好。