Yan Q S, Zhong J S, Zhou H, Zhou J Y
Department of Respiratory Medicine, the First Affiliated Hospital, College of Medical, Zhejiang University, Hangzhou 310003, China (Yan Qinshu is working on the Department of Respiratory Medicine, Affiliated Hospital of Yongkang Health School, Zhejiang Province, Jinhua 321300, China).
Department of Hospital Sensation, the First People's Hospital of Yongkang City, Zhejiang Province, Jinhua 321300, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2019 Jul 12;42(7):510-514. doi: 10.3760/cma..j.issn.1001-0939.2019.07.010.
To investigate the clinical and epidemiological characteristics of influenza A (H3N2) infected patients in Jinhua area, and therefore to improve the understanding of infection with H3N2 influenza virus. The pharynx swab specimens for pathogenic detection were collected from acute respiratory infection (ARI) cases in the fever clinic of the sentinel hospital in Jinhua area from 2014 to 2017. Descriptive statistics method was used to analyze the clinical features and pathogenics characteristics of the patients infected with H3N2 influenza virus. The test or χ(2) test of independent samples were used for comparison between groups. A total of 3 803 cases of acute respiratory infection (ARI) were reported in the sentinel hospital in Jinhua area from 2014 to 2017. Among them, 245 cases (6.4%) of H3N2 influenza were diagnosed, including 153 males (62.4%) and 92 females (37.6%), aged from 0.5 to 95 years, with an average age of (50.1+15.7) years. They were divided into 5 age groups, with 107 (43.7%) patients aged 60 years and older. The incidence of major diseases was 43.7%. There was no significant difference in the gender in different age groups (χ(2)=4.581, 0.333). The seasonal peak of H3N2 influenza A virus infection was mainly in summer (In June-September), but was also seen in other months. In the 4 years from 2014 to 2017, there were a total of 4 peaks, which occurred in July-September, July-August, June-August, and June-August. The body temperature of most patients (73.1%) was between 38.0 and 38.9 ℃. The main positive signs of H3N2 influenza A virus infection were different degrees of pharyngeal hyperemia and tonsillar enlargement. Fever (>38 ℃), cough, dizziness, fatigue, sore throat, headache, chills, shortness of breath, runny nose, myalgia, expectoration, nasal congestion were the main symptoms of H3N2 cases. The proportion of abnormal X-ray/CT manifestations in H3N2 influenza A virus infection cases was lower than that of other influenza viruses. 89.8% of the patients were positive for H3N2 influenza A. The average lymphocyte count was (1.1±0.5) × 10(9)/L, total platelet count (157±39) × 10(9)/L in H3N2 influenza A infection group, which were lower than those in other influenza positive patients [(1.2±0.6)×10(9)/L and (165±42) × 10(9)/L], while the neutrophil count (3.6±0.8) × 10(9)/L was higher than that in other influenza positive patients (3.4±1.0) × 10(9)/L(all 0.05). Patients with H3N2 influenza A in Jinhua mostly presented with throat congestion and tonsillar enlargement in varying degrees, fever (>38 ℃), cough and sputum production. The seasonal peak of influenza A was in summer (June-September). Elderly aged 60 years or older were the susceptible group.
为调查金华地区甲型H3N2流感感染患者的临床和流行病学特征,进而提高对H3N2流感病毒感染的认识。收集了2014年至2017年金华地区哨点医院发热门诊急性呼吸道感染(ARI)病例的咽拭子标本进行病原学检测。采用描述性统计方法分析H3N2流感病毒感染患者的临床特征和病原学特征。组间比较采用独立样本t检验或χ²检验。2014年至2017年金华地区哨点医院共报告3803例急性呼吸道感染(ARI)病例。其中,诊断出245例(6.4%)H3N2流感,包括男性153例(62.4%),女性92例(37.6%),年龄0.5至95岁,平均年龄(50.1±15.7)岁。他们被分为5个年龄组,60岁及以上患者107例(43.7%)。重大疾病发病率为43.7%。不同年龄组性别差异无统计学意义(χ² = 4.581,P = 0.333)。甲型H3N2流感病毒感染的季节高峰主要在夏季(6至9月),但其他月份也有出现。2014年至2017年的4年中,共有4个高峰,分别出现在7至9月、7至8月、6至8月和六月至八月。大多数患者(73.1%)体温在38.0至38.9℃之间。甲型H3N2流感病毒感染的主要阳性体征为不同程度的咽部充血和扁桃体肿大。发热(>38℃)、咳嗽、头晕、乏力、咽痛、头痛、寒战、气短、流涕、肌痛、咳痰、鼻塞是H3N2病例主要症状。甲型H3N2流感病毒感染病例中X线/CT异常表现的比例低于其他流感病毒。89.8%的患者甲型H3N2流感检测呈阳性。甲型H3N2流感感染组平均淋巴细胞计数为(1.1±0.5)×10⁹/L,血小板总数为(157±39)×10⁹/L,低于其他流感阳性患者[(1.2±0.6)×10⁹/L和(165±42)×10⁹/L],而中性粒细胞计数(3.6±0.8)×10⁹/L高于其他流感阳性患者(3.4±1.0)×10⁹/L(均P<0.05)。金华地区甲型H3N2流感患者大多表现为不同程度的咽喉充血和扁桃体肿大、发热(>38℃)、咳嗽咳痰。甲型流感季节高峰在夏季(6至9月)。60岁及以上老年人为易感人群。