中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2010年
12期
722-726
,共5页
袁虹%杨桂林%刘映霞%刘威龙%王兰天%方木通%李国保%纪玉玲%徐六妹%陆普选%周伯平
袁虹%楊桂林%劉映霞%劉威龍%王蘭天%方木通%李國保%紀玉玲%徐六妹%陸普選%週伯平
원홍%양계림%류영하%류위룡%왕란천%방목통%리국보%기옥령%서륙매%륙보선%주백평
流感病毒A型,H1N1亚型%流感%人,肺炎%病毒载量
流感病毒A型,H1N1亞型%流感%人,肺炎%病毒載量
류감병독A형,H1N1아형%류감%인,폐염%병독재량
Influenza A virus,H1N1 subtype%Influenza,human%Pneumonia%Viral load
目的 了解轻型和重型甲型H1N1流行性感冒(流感)患者的临床和实验室特征、病毒载量及排毒时间.方法 对深圳地区70例轻型和16例合并肺炎的重型甲型H1N1流感患者采用实时荧光定量PCR方法,检测其甲型H1N1流感病毒载量.比较年龄＜14岁和≥14岁患者,以及轻型无肺炎和重型合并肺炎患者的病毒载量和病毒清除时间的差异.统计学方法采用t检验或卡方检验.结果 甲型H1N1流感患者最常见的临床表现是发热、咳嗽和扁桃体肿大.重型患者咳嗽、呼吸困难比例和最高体温较轻型患者显著增高(x2=10.9、14.3,t=3.65,均P＜0.01).重型患者WBC计数、ALT水平较轻型患者显著升高(t=3.2、2.4,均P＜0.05).重型患者胸部影像学类似间质性肺炎,多为磨玻璃样影.＜14岁患者的病毒载量和病毒清除时间较≥14岁的显著升高[(4.86±1.23)lg比(4.17±0.89)lg,t=2.3,P＜0.05]或延长[(5.33±0.49)d比(3.63±0.28)d,t=3.4,P＜0.01],重型患者病毒载量和病毒清除时间较轻型患者显著升高[(6.36±1.44)lg比(4.35±0.99)lg,t=6.1,P＜0.01]或延长[(5.75±1.77)d比(4.24±1.96)d,t=3.2,P＜0.01).结论 甲型H1N1流感患者年龄和病情严重程度与病毒载量和排毒时间存在显著相关性.
目的 瞭解輕型和重型甲型H1N1流行性感冒(流感)患者的臨床和實驗室特徵、病毒載量及排毒時間.方法 對深圳地區70例輕型和16例閤併肺炎的重型甲型H1N1流感患者採用實時熒光定量PCR方法,檢測其甲型H1N1流感病毒載量.比較年齡＜14歲和≥14歲患者,以及輕型無肺炎和重型閤併肺炎患者的病毒載量和病毒清除時間的差異.統計學方法採用t檢驗或卡方檢驗.結果 甲型H1N1流感患者最常見的臨床錶現是髮熱、咳嗽和扁桃體腫大.重型患者咳嗽、呼吸睏難比例和最高體溫較輕型患者顯著增高(x2=10.9、14.3,t=3.65,均P＜0.01).重型患者WBC計數、ALT水平較輕型患者顯著升高(t=3.2、2.4,均P＜0.05).重型患者胸部影像學類似間質性肺炎,多為磨玻璃樣影.＜14歲患者的病毒載量和病毒清除時間較≥14歲的顯著升高[(4.86±1.23)lg比(4.17±0.89)lg,t=2.3,P＜0.05]或延長[(5.33±0.49)d比(3.63±0.28)d,t=3.4,P＜0.01],重型患者病毒載量和病毒清除時間較輕型患者顯著升高[(6.36±1.44)lg比(4.35±0.99)lg,t=6.1,P＜0.01]或延長[(5.75±1.77)d比(4.24±1.96)d,t=3.2,P＜0.01).結論 甲型H1N1流感患者年齡和病情嚴重程度與病毒載量和排毒時間存在顯著相關性.
목적 료해경형화중형갑형H1N1류행성감모(류감)환자적림상화실험실특정、병독재량급배독시간.방법 대심수지구70례경형화16례합병폐염적중형갑형H1N1류감환자채용실시형광정량PCR방법,검측기갑형H1N1류감병독재량.비교년령＜14세화≥14세환자,이급경형무폐염화중형합병폐염환자적병독재량화병독청제시간적차이.통계학방법채용t검험혹잡방검험.결과 갑형H1N1류감환자최상견적림상표현시발열、해수화편도체종대.중형환자해수、호흡곤난비례화최고체온교경형환자현저증고(x2=10.9、14.3,t=3.65,균P＜0.01).중형환자WBC계수、ALT수평교경형환자현저승고(t=3.2、2.4,균P＜0.05).중형환자흉부영상학유사간질성폐염,다위마파리양영.＜14세환자적병독재량화병독청제시간교≥14세적현저승고[(4.86±1.23)lg비(4.17±0.89)lg,t=2.3,P＜0.05]혹연장[(5.33±0.49)d비(3.63±0.28)d,t=3.4,P＜0.01],중형환자병독재량화병독청제시간교경형환자현저승고[(6.36±1.44)lg비(4.35±0.99)lg,t=6.1,P＜0.01]혹연장[(5.75±1.77)d비(4.24±1.96)d,t=3.2,P＜0.01).결론 갑형H1N1류감환자년령화병정엄중정도여병독재량화배독시간존재현저상관성.
Objective To analyze clinical and laboratory features, viral load and viral shedding period of patients with mild or severe H1N1 influenza A infection. Methods Seventy mild cases and 16 severe cases with concurrent pneumonia were included from Shcnzhen area for analysis.Nasopharyngeal-swab specimens of patients were collected and viral load was detected by real-time quantitative polymerase chain reaction (PCR) assay during their hospitalization. The viral load and viral shedding period were compared between patients over 14 years old and less than 14 years old, and between 70 mild cases without pneumonia and 16 severe cases with pneumonia. The statistic analysis was performed using t test and chi square test. Results The most common symptoms and signs of the patients were fever, cough and enlargement of tonsils. However, the severe cases suffered more frequently from cough, dyspnea and high fever compared with the mild cases (x2 = 10. 9 and 14.3, respectively, t=3.65; both P＜0.01 ). The levels of white blood cell (WBC) count and alanine arninotransferase (ALT) of severe patients were both significantly higher than those of mild patients(t= 3.2, 2.4,respectively; both P＜0.05). The chest radiology of the severe cases showed interstitial pneumonia,mostly with ground glass image. The viral load of patients under 14 years was significantly higher than those over 14 years [(4.86± 1.23) lg vs (4. 17±0.89) lg; t=2.3, P＜0.05], and the viral shedding period of patients under 14 years was significantly longer than those over 14 years [(5.33±0. 49) d vs(3. 63±0.28) d; t=3.4, P＜0.01]. The severe patients also displayed significantly higher viral load and prolonged viral shedding period than the mild patients [(6. 36±1. 44) lg vs (4. 35±0.99) lg, t=6.1,P＜0.01; (5.75±1.77) d vs (4. 24±1. 96) d, t=3.2, P＜0.01]. Conclusion Age anddisease severity of patients with H1N1 influenza A infection are significantly associated with viral load and viral shedding period.
