Kang Seok Jeong, Lee Jae Min, Hah Jeong Ok, Shim Ye Jee, Lee Kun Soo, Shin Hyun Jung, Kim Heung Sik, Choi Eun Jin, Jeon So Eun, Lim Young Tak, Park Ji Kyeong, Park Eun Sil
Department of Pediatrics, College of Medicine, Yeungnam University, Daegu, Korea.
Korean J Pediatr. 2011 Mar;54(3):117-22. doi: 10.3345/kjp.2011.54.3.117. Epub 2011 Mar 31.
Natural history and consequences of the novel 2009 influenza A H1N1 (2009 H1N1) infection in immunocompromised pediatric patients are not yet fully understood. In this study, we investigated the clinical features and outcomes of the 2009 H1N1 infection in pediatric patients with hematological and oncological diseases.
We retrospectively reviewed the medical records of 528 patients who had hematological and oncological diseases and who were treated at 7 referral centers located in the Yeungnam region. Among the 528 patients, 27 with definite diagnosis of 2009 H1N1 infection were the subjects of this study. All patients were divided into the following 3 groups: patients who were receiving chemotherapy (group 1), patients who were immunosuppressed due to a non-malignant hematological disease (group 2), and patients who were off chemotherapy and had undergone their last chemotherapy course within 2 years from the influenza A pandemic (group 3).
All 28 episodes of 2009 H1N1 infection were treated with the antiviral agent oseltamivir (Tamiflu®), and 20 episodes were treated after hospitalization. Group 1 patients had higher frequencies of lower respiratory tract infection and longer durations of fever and hospitalization as compared to those in group 2. Ultimately, all episodes resolved completely with no complications.
These results suggest that early antiviral therapy did not influence the morbidity or mortality of pediatric patients with hematological and oncological diseases in the Yeungnam region of Korea after the 2009 H1N1 infection. However, no definite conclusions can be drawn because of the small sample size.
免疫功能低下的儿科患者感染新型2009甲型H1N1流感(2009 H1N1)的自然病史及后果尚未完全明确。在本研究中,我们调查了患有血液学和肿瘤学疾病的儿科患者感染2009 H1N1的临床特征及转归。
我们回顾性分析了位于岭南地区的7家转诊中心收治的528例患有血液学和肿瘤学疾病患者的病历。在这528例患者中,27例确诊为2009 H1N1感染的患者为本研究对象。所有患者被分为以下3组:接受化疗的患者(第1组)、因非恶性血液学疾病导致免疫抑制的患者(第2组)、停止化疗且在甲型流感大流行后2年内完成最后一个化疗疗程的患者(第3组)。
所有28例2009 H1N1感染均使用抗病毒药物奥司他韦(达菲®)进行治疗,20例在住院后接受治疗。与第2组相比,第1组患者下呼吸道感染的发生率更高,发热和住院时间更长。最终,所有病例均完全康复,无并发症发生。
这些结果表明,早期抗病毒治疗对韩国岭南地区2009 H1N1感染后患有血液学和肿瘤学疾病的儿科患者的发病率或死亡率没有影响。然而,由于样本量较小,无法得出明确结论。