目的 探讨甲型H1N1流感不同临床类型及不同阶段C反应蛋白（CRP）动态变化特征。 方法 回顾性分析2009年5月10日－2010年1月18日实验室确诊的271例甲型H1N1流感住院患者不同临床类型、疾病不同阶段CRP动态变化情况。 结果 甲型H1N1流感患者感染初期CRP较正常升高，且升高程度随着病情的加重而更明显；CRP在治疗第3天即明显下降或接近正常，其动态改变在不同疾病严重程度组间无明显差异；有脏器功能损害者CRP较无脏器功能损害者明显升高；多个脏器损害CRP较单一脏器损害组明显升高。 结论 甲型H1N1流感CRP升高程度可间接反映其疾病严重程度和脏器功能损害多少。
【摘要】 目的 了解北京地区400例新型甲型H1N1流感患者的流行病学和临床特征，总结规律，进一步指导临床诊治。 方法 2009年5-12月期间，收治400例甲型H1N1流感确诊病例，主要采用描述性流行病学方法对患者资料进行回顾性分析，并运用单因素方差分析的方法对结果进行检验。 结果 患者以青年和儿童人群为主，47.0%的患者有明确甲型H1N1流感接触史，主要症状包括发热（98.8%）、咳嗽（85.8%）、咽痛（58.5%）。咽部充血（94.0%）和扁桃体肿大（49.5%）为主要体征。外周血白细胞正常或偏低，349例（82.3%）患者血清铁降低，268例（72.6%）患者C反应蛋白升高。在发病后不同时间内给予奥司他韦治疗的患者发热持续时间和咽拭子的阴转时间有显著差异（Plt;0.001）。 结论 新型甲型H1N1流感发病多以青年和儿童人群为主，以流感样症状为主，多数症状轻微，预后良好，C反应蛋白和血清铁的变化可能对于早期诊断有指导价值，奥司他韦早期抗病毒治疗可以缩短病程。【Abstract】 Objective To investigate the clinical and epidemiologic characteristics of pandemic influenza A (H1N1) virus infection in Beijing. Methods The epidemiological information and clinical characteristics of 400 patients with pandemic influenza A (H1N1) virus infection hospitalized in Beijing 302 Hospital from May to December, 2009 were analyzed retrospectively by descriptive epidemiology. One-way ANOVA was used to assess the results. Results H1N1 virus infection preferentially affected adolescents and young adults. The mean age of the patients was 23 years. A total of 189 (47.0%) of the patients had an identifiable epidemiologic link to another confirmed patient. The most common symptoms were fever (98.8%), cough (85.8%) and sore throat (58.5%). The main physical signs were pharyngeal portion congestion (94.0%) and antiadoncus (49.5%). The number of leukocytes in the peripheral blood was normal or low. The decreased serum iron and elevated C-reaction protein were found in 82.3% and 72.6% of the patients. There was significant difference in the duration of fever and viral shedding from throat swabs among the patients who accept the antiviral medication within the different time. Conclusion H1N1 virus infection preferentially affects adolescents and young adults, and presents with influenza-like illness. The clinical course of H1N1 virus infection is generally mild. The change of C-reaction protein and serum iron may be favorable for the diagnosis of H1N1. Early antiviral treatment may shorten the duration of fever and viral shedding.
重视和总结我国临床诊治甲型H1N1流感的经验
糖皮质激素在甲型H1N1流感中的应用探讨
目的 探讨妊娠期甲型H1N1流感的临床特点。 方法 对乌鲁木齐市妇幼保健院2009年11月-2010年1月收治的妊娠期甲型H1N1流感临床资料进行回顾性分析。 结果 同期住院非甲流孕产妇1 856例，确诊甲型H1N1流感52例，发病率2.7%。妊娠期甲型H1N1流感的发热时限及不同孕期与病程时限均无相关关系。使用磷酸奥司他韦(达菲)治疗23例，较未使用此药物患者病程显著缩短[(4.79±2.04) d比(7.26±3.77) d，Plt;0.05]。合并肺炎6例，病程较无合并症患者显著延长[(9.83±4.70) d比(5.37±2.54) d，Plt;0.05]。 结论 妊娠期甲型H1N1流感应予以高度重视，在早预防、早诊断及早治疗的基础上，提早预防合并症的发生。明确诊断后及早使用磷酸奥司他韦可缩短疗程。
【摘要】 目的 总结甲型H1N1流感病毒性肺炎患者的胸部X线和CT表现特征。 方法 回顾分析2009年3月-11月3例经临床表现及病原学检查证实的甲型H1N1流感病毒性肺炎的胸部X线、CT表现。 结果 肺部病灶多呈散在小片状高密度影，边缘模糊，邻近胸膜；病变最常累及肺基底段；病灶多有少量胸腔积液；病灶有扩散迅速，合理用药后消失较快的特点；病灶吸收落后于临床表现。 结论 甲型H1N1流感病毒性肺炎的X线、CT表现具有一定的特点，总结并掌握这些特点，有利于早期诊断。其确诊有赖于实验室检查和流行病学调查。【Abstract】Objective To explore the chest X-ray, CT manifestations of pneumonia of patients with influenza virus A/H1N1 infection. Methods The pulmonary X-ray and CT findings of 3 patients who were confirmed by laboratory results and epidemiology with infection of influenza virus A/H1N1 were retrospectively analyzed between March 2009 to November 2009. Results Both sides of the lung field showed many small cloudy infiltration in chest X-ray and CT film. The lesions of the lung were mostly near the pleural. They were often found in basal segment. Pleural effusion may be observed. Radiology dynamic changes showed the diffusion of the lesions of the lung was quick in a short time, and scattered and disappeared quickly after rational use of drugs. The lesions vanished later than clinical disappearance. The lesions of the lung may appear fibrosis at the period of the end. Conclusion Some radiographic characteristics exist in the pneumonia of patients with influenza virus A/H1N1 infection. It will be helpful for early diagnosis when getting familiar with its X-ray and CT manifestations, but the final diagnosis depends on the laboratory results and epidemiological history.