Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Influenza Other Respir Viruses. 2012 Nov;6(6):e152-61. doi: 10.1111/j.1750-2659.2012.00410.x. Epub 2012 Jul 30.
To better understand clinical and laboratory characteristics in children, adults, and patients with lung involvement suffering 2009 pandemic influenza A (H1N1).
A total of 442 patients with 2009 pandemic influenza A (H1N1) were retrospectively analyzed.
Comparing to their adult counterpart (n=55), pediatric patients (n=387) had significantly higher frequencies of fever, rhinorrhea, cough, sore throat, nausea/vomiting, and longer length of fever; lower frequencies of chest pain and dyspnea; higher incidence of lymphopenia; and lower incidence of elevated serum C-reactive protein. Among the 227 patients with radiographs available, lung involvement was found in 19 (8.4%) (52.6% consolidation and 47.4% interstitial infiltrations), including 18 children and one adult. One child with lung consolidation died of multiorgan failure. Significant findings in patients with lung involvement included predominant young age (≤ 10 years), prolonged fever, and delayed oseltamivir therapy (≥ 48 hours after onset of illness); higher frequencies of dyspnea, nausea/vomiting, and altered consciousness; and higher incidences of leukopenia, elevated serum creative kinase, and lactic dehydrogenase.
Among patients with 2009 pandemic influenza A (H1N1), we found significant difference in clinical manifestations between children and adults, and significant differences in clinical and laboratory manifestations between patients with lung involvement and those without. On the basis of data from this study and the existing literature, early treatment with oseltamivir is recommended for patients with 2009 pandemic influenza A (H1N1), regardless of age.
为了更好地了解儿童、成人和肺部受累患者中 2009 年甲型流感（H1N1）的临床和实验室特征。
回顾性分析了 442 例 2009 年甲型流感（H1N1）患者。
与成人患者（n=55）相比，儿科患者（n=387）发热、流涕、咳嗽、咽痛、恶心/呕吐的频率更高，发热持续时间更长；胸痛和呼吸困难的频率更低；淋巴细胞减少的发生率更高；血清 C 反应蛋白升高的发生率更低。在 227 例有胸片的患者中，发现肺部受累 19 例（8.4%）（52.6%实变，47.4%间质浸润），包括 18 例儿童和 1 例成人。1 例肺部实变的患儿死于多器官功能衰竭。肺部受累患者的显著发现包括主要为年轻（≤10 岁）、发热时间延长、奥司他韦治疗延迟（发病后≥48 小时）；呼吸困难、恶心/呕吐和意识改变的频率更高；白细胞减少、血清肌酸激酶和乳酸脱氢酶升高的发生率更高。
在 2009 年甲型流感（H1N1）患者中，我们发现儿童和成人的临床表现存在显著差异，肺部受累患者和无肺部受累患者的临床表现和实验室表现也存在显著差异。基于本研究和现有文献的数据，建议对 2009 年甲型流感（H1N1）患者，无论年龄大小，均应尽早使用奥司他韦进行治疗。
