摘要
目的了解2009年深圳市收治的30例甲型H1N1流行性感冒（流感）确诊病例的流行病学和临床特点。方法30例患者均经2次鼻拭子、咽拭子甲型H1N1流感病毒核酸检测阳性（RT—PCR法），此后每天检测病毒核酸直至连续2d均阴性。第1次病毒核酸检测阳性后立即开始奥司他韦（商品名为达菲）或“中药I号”抗病毒治疗，5d为一疗程。收集患者流行病学、临床和一般实验室资料。统计学处理采用t检验。结果29例患者为输人性病例，另1例为二代病例，系7个月女婴。发病平均年龄（20．42±12．59）岁，离开疫区至发病的平均时间为（53．33±53．08）h，其中2例离开疫区超过8d才发病，其密切接触人群中发现1例隐性感染者。30例患者均有发热，平均最高体温（38．40±0．80）℃，其他临床症状依次为咳嗽17例（56．7％）、流涕9例（30．0％）、咽痛9例（30．0％）、头痛7例（23．3％）、鼻塞2例（6．7％）、肌肉酸痛1例（3．3％）。22例患者在抗病毒治疗5d内病毒核酸转阴，8例在抗病毒治疗第6天或以后病毒核酸转阴。21例在病程7d内病毒核酸转阴，9例在起病后病毒核酸阳性持续8d或以上，后者较前者中性粒细胞计数明显下降，分别为（1．47±1．03）×10^9／L和（2．69±1．63）×10^9／L（t=2．06，P=0．048），血常规异常持续时间也明显延长，分别为（2．78±2．49）d和（0．71±1．31）d，差异有统计学意义（t=2．34，P=0．006）。结论甲型H1N1流感发病年龄偏低，临床症状不严重。部分病例潜伏期可能超过7d，病程7d或抗病毒治疗5d后仍有可能检出病毒，存在亚临床隐性感染的可能。血常规变化与病毒核酸阳性的持续时间存在一定关系。
Objective To investigate the epidemiology and clinical manifestation of 30 confirmed cases of influenza A（H1N1） in Shenzhen city in 2009. Methods Testing positive for influenza A （H1N1） virus nucleic acid by reverse transcription-polymerase chain reaction （RT-PCR） with nose swabs and pharynx swabs two times were showed in 30 patients. Thereafter, the virus nucleic acid was detected once per day until the results were negative on two consecutive days. The antiviral treatment with oseltamivir or the Chinese medicine I started immediately after testing positive by RT PCR at the first time and tasted for 5 days. The epidemiological, clinical and laboratory data of all patients were collected. Data were analyzed by t test. Results Twenty-nine patients were imported cases. The remaining one was secondary case who was a 7-month old female infant. The mean age of all patients was （20.42± 12.59） years old. The time from onset to leaving epidemic areas was （53.33± 53.08） hours. There were two patients who left the epidemic areas for over 8 days before the onset of illness. One recessive infected case was found in the close contacts of the confirmed cases. The study reported that all patients had fevers. The mean highest body temperature was （38.40 ± 0. 80） ℃. Other symptoms in turn were 17 with coughing （56.7%）, 9 with snivel （30.0%）, 9 with sore throat （30. 0%）, 7 with headache （23. 3%）, 2 with nasal obstruction （6. 7%） and 1 with muscle ache （3.3T）. Seventy-three point three percent （22/30） of patients whose virus nucleic acid turned negative in 5 days of antiviral treatments, and 8 turned negative on day 6 or after 6 days of treatment. Seventy percent （21/30） of patients whose virus turned negative in 7 days of duration, the other 30. 0 % （ 9 / 30 ） of cases whose virus were still positive after ？ days of duration. Comparing with the former, the neutrophilic granulocyte count of the latter decreased significantly [ （1.47 ± 1.03）×10^9/L vs （2.69 ± 1.63）×10^9/L, t=2.06, P=0.048]. The days of abnormal hemogram of the latter was prolonged obviously [（2.78±2.49） dvs （0.71±1.31） d, t=2.34, P=0.006]. Conclusions The ageofonset appears young and clinical manifestations appear slight in the patients with influenza A（H1N1）. The incubation period of some cases probably exceeds 7 days, and it is possible to detect.virus after 7 days of duration or 5 days of antiviral treatment. Subclinical recessive infection could occur. The change of hemogram is correlated with the duration of testing positive of virus nucleic acid.
出处
《中华传染病杂志》
CAS
CSCD
北大核心
2009年第10期582-585,共4页
Chinese Journal of Infectious Diseases
