CAJ | 학술논문

目的分析杭州市萧山区人感染H7N9禽流感病例临床特征,为其诊治提供依据.方法对每例确诊的H7N9感染病例开展流行病学调查,并收集临床资料,采用描述流行病学方法分析其发病特征.结果 6例人感染H7N9禽流感确诊病例,中位发病年龄58岁(37～78岁),男女比例为1∶2,4例有基础疾病.患者直接或间接接触禽类后5～7 d发病,初期多以咳嗽或腹泻为首发症状,并迅速进展为肺炎或重症肺炎.5例血常规显示白细胞和淋巴细胞数均减少.肺部影像学检查均表现为一侧或双侧肺炎,以渗出性病变为主.2例并发急性呼吸窘迫综合征患者,最终因多器官功能衰竭死亡.结论普通流感样症状或消化道症状为H7N9感染的首发症状；老年人伴基础疾病者,易出现重症肺炎等并发症；影像学以及血象检查有助于疾病的确诊.
목적 분석항주시소산구인감염H7N9금류감병례림상특정,위기진치제공의거.방법 대매례학진적H7N9감염병례개전류행병학조사,병수집림상자료,채용묘술류행병학방법분석기발병특정.결과 6례인감염H7N9금류감학진병례,중위발병년령58세(37～78세),남녀비례위1∶2,4례유기출질병.환자직접혹간접접촉금류후5～7 d발병,초기다이해수혹복사위수발증상,병신속진전위폐염혹중증폐염.5례혈상규현시백세포화림파세포수균감소.폐부영상학검사균표현위일측혹쌍측폐염,이삼출성병변위주.2례병발급성호흡군박종합정환자,최종인다기관공능쇠갈사망.결론 보통류감양증상혹소화도증상위H7N9감염적수발증상；노년인반기출질병자,역출현중증폐염등병발증；영상학이급혈상검사유조우질병적학진.
Objective To analyze clinical features of human infection with avian influenza A (H7N9) in Xiaoshan District of Hangzhou,in order to provide scientific basis for diagnosis and treatment.Methods Epidemiological investigation were conducted for each confirmed case of H7N9 virus infection,and the clinical data were collected.The incidence characteristics were analyzed by descriptive epidemiology method.Results The median age of the 6 confirmed cases was 58 years (37-78 years),the proportion of male to female was 1∶2,and 4 cases complicated with basic disease.Patients onset 5-7 days after they direct or indirect contacted with poultry,the early clinical symptom was cough or diarrhea,and rapidly progressed to pneumonia or severe pneumonia.Leucocyte and lymphocyte both reduced in 5 cases.Chest X-ray or CT showed pneumonia in one side or double sides,with exudative lesion mainly.Two cases complicated with acute respiratory distress syndrome,eventually died of multiple organ failures.Conclusions Influenza-like or gastrointestinal symptoms are the early clinical symptom of the cases.The elderly cases with chronic disease can easily have severe complications,such as severe pneumonia.X-ray chest films and blood routine examination is helpful to diagnose the human infection with H7N9.