摘要
目的了解现役军人甲型H1N1流感患者的临床特征和治疗情况。方法对空军总医院2009年9月20日-12月30日收治的176例驻京部队现役军人甲型H1N1流感住院患者的临床资料进行回顾性分析。按不同的抗病毒治疗方法将166例患者(除外转院2例及有并发症的8例)分为奥司他韦组(n=74,给予磷酸奥司他韦胶囊)和双黄连组(n=92,给予双黄连粉针静脉输注+感冒清热冲剂),比较两组治疗效果。结果 176例患者,确诊34例,临床诊断病例142例,年龄22.8±5.5(17～47)岁。临床症状以轻症为主,符合重症患者诊断标准的仅4例(2.27%)。13例患者发病前曾接种过甲型H1N1流感病毒疫苗。居前5位的临床症状分别为:发热176例(100%),咳嗽133例(75.57%),咽痛123例(69.89%),咳痰80例(45.45%),肌肉酸痛64例(36.36%)。主要体征分别为:咽部充血162例(92.05%),扁桃体肿大77例(43.75%)。外周血白细胞总数正常者156例(90.69%),降低7例(4.07%),升高9例(5.23%);中性粒细胞升高57例(33.14%),正常99例(57.56%),降低16例(9.30%);淋巴细胞升高16例(9.30%),正常110例(63.95%),降低46例(26.75%);65.43%(106/162)的患者血清C-反应蛋白升高。12例(6.82%)胸部X线检查有不同程度改变。奥司他韦组在住院天数(5.12±1.36d)和24h内体温正常、临床表现明显改善的患者比例(82.43%,61/74)等方面明显优于对照组(分别为5.65±1.81d,P<0.05;63.04%,58/92,P<0.01)。奥司他韦胶囊治疗过程中未发现明显不良反应。结论本组现役军人患者绝大多数病情较为温和,预后良好,临床主要表现与普通人群感染者类似。
Objective To summarize the clinical features and treatment of servicemen infected with influenza A （H1N1）. Methods The clinical data of 176 servicemen suffering from influenza A （H1N1） hospitalized in our hospital from Sep. 20 to Dec. 30 in 2009 were analyzed retrospectively. With exception of 2 patients transferred to another hospital and 8 patients with complications,166 patients were randomly divided into oseltamivir group （n=74,treated with oseltamivir capsule） and control group （n=92,received SHUANGHUANGLIAN injection plus GANMAOQINGRR concoction）. Curative effects were compared between the two groups. Results Of the 176 patients,34 were finally diagnosed and 142 were clinically diagnosed as influenza A （H1N1）. The mean age of patients was 22.8±5.5 （17~47） yrs. Of them only 4 cases （2.27%） the diagnosis of severe inffuenza met the criterion. 13 patients had been vaccinated against influenza A （H1N1） before. The five major clinical symptoms were fever （176,100%）,cough （133,75.57%）,sore throat （123,69.89%）,expectoration （80,45.45%） and muscular pain （64,36.36%）. The main physical symptoms were throat congestion （162,92.05%） and swelling of tonsils （77,43.75%）. Among 172 patients,the leukocyte count in peripheral blood was normal in 156 patients （90.69%）,decreased in 7 patients （4.07%） and increased in 9 patients （5.23%）; the neutrophil count was normal in 99 patients （57.56%）,increased in 57 patients （33.14%） and decreased in 16 patients （9.30%）; the lymphocyte count was normal in 110 patients （63.95%）,increased in 16 patients （9.30%） and decreased in 46 patients （26.75%）. The serum C-reaction protein was found to be increased in 65.43% （106/162） of patients. Twelve patients （6.82%） showed different extent of abnormal changes in chest X-ray films. Patients in oseltamivir group recovered earlier than those in control group with shorter hospitalized stay （5.12±1.36d vs 5.65±1.81d,P0.05）,with earlier recovery of normal temperature within 24 hours,and improvement in clinical conditions （82.43% vs 63.04%,P0.01）. No conspicuous adverse effect occurred during oseltamivir administration. Conclusions Most of the servicemen suffering from influenza A （H1N1） run a smooth course with a good prognosis. The major clinical features are similar to that of ordinary population.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2010年第8期1016-1018,共3页
Medical Journal of Chinese People's Liberation Army
