立陶宛考纳斯市住院的 2009 年大流行性流感 A（H1N1）成年患者。

Hospitalized adult patients with 2009 pandemic influenza A (H1N1) in Kaunas, Lithuania.

机构信息

Department of Infectious Diseases, Medical Academy, Lithuanian University of Health Sciences, Baltijos 120, 47116 Kaunas, Lithuania.

出版信息

Medicina (Kaunas). 2011;47(1):11-8.

PMID:21681006

Abstract

UNLABELLED

The objective of this study was to identify case characteristics and clinical course of the disease in patients hospitalized with 2009 pandemic influenza A (H1N1) infection during the first wave of the pandemic and to identify risk factors associated with the complicated course of illness.

MATERIAL AND METHODS

A retrospective study of adult cases of the laboratory-confirmed 2009 pandemic influenza A (H1N1) virus admitted to three hospitals in Kaunas between November 1, 2009, and March 15, 2010, was carried out. The main outcome measures were clinical characteristics, risk factors for complicated disease, treatment, and clinical course of the disease.

RESULTS

The study enrolled 121 of the 125 patients hospitalized due to 2009 pandemic influenza A (H1N1) virus infection. The median age was 31 years (range, 18-83); 5% of the patients were aged more than 65 years. Pregnant and postpartum women comprised 26% of all hospitalized cases. Nearly half (49.5%) of those who underwent chest radiography had findings consistent with pneumonia, which was bilateral in one-third of cases. The risk to have pandemic influenza complicated by pneumonia increased significantly with one-day delay from symptom onset to antiviral treatment (OR, 2.241; 95% CI, 1.354-3.710). More than half (57%) of the patients received antiviral treatment. In 45% of the treated patients, antiviral drugs were administered within 48 hours from symptom onset. Intensive care was required in 7.4% of the cases. The overall mortality was 5% (6/121). The median age of the patients who died was 43.5 years (range, 23-62); 4 patients had been previously healthy, 1 patient suffered from chronic lympholeukemia, and 1 patient was a pregnant woman.

CONCLUSION

The 2009 pandemic influenza A (H1N1) caused considerable morbidity in a significant proportion of hospitalized adults. The main risk factor associated with the complicated course of illness was delayed antiviral treatment.

摘要

目的

本研究旨在确定在大流行第一波期间因 2009 年甲型流感（H1N1）感染住院的患者的病例特征和疾病临床过程，并确定与疾病复杂过程相关的危险因素。

材料与方法

对 2009 年 11 月 1 日至 2010 年 3 月 15 日期间在考纳斯的三所医院因实验室确诊的 2009 年甲型流感（H1N1）病毒住院的成年病例进行回顾性研究。主要观察指标为临床特征、疾病复杂的危险因素、治疗和疾病临床过程。

结果

该研究纳入了 125 例因 2009 年甲型流感（H1N1）病毒感染住院的患者中的 121 例。中位年龄为 31 岁（范围，18-83 岁）；5%的患者年龄大于 65 岁。妊娠和产后妇女占所有住院病例的 26%。近一半（49.5%）接受胸部 X 线检查的患者影像学表现符合肺炎，其中三分之一为双侧肺炎。从症状出现到开始抗病毒治疗的时间每延迟一天，发生大流行流感合并肺炎的风险显著增加（OR，2.241；95%CI，1.354-3.710）。超过一半（57%）的患者接受了抗病毒治疗。在接受治疗的患者中，45%的患者在症状出现后 48 小时内使用了抗病毒药物。7.4%的患者需要重症监护。总的死亡率为 5%（6/121）。死亡患者的中位年龄为 43.5 岁（范围，23-62 岁）；4 例患者既往健康，1 例患有慢性淋巴细胞白血病，1 例为孕妇。