CAJ | 학술논문

目的分析不同孕期重症甲型H1N1流感患者的临床特征.方法回顾性收集2009年9月1日至12月31日中国大陆地区27个省市综合医院或传染病医院收治的394例重症或危重症甲型H1N1流感孕妇的临床资料,比较孕早、中、晚期患者的临床特点.确诊病例定义为甲型H1N1流感病毒核酸检测阳性,并且符合甲型H1N1流感重症和危重症的诊断标准.基于各变量有完整记录的病例数来计算各变量数据百分比.结果 394例患者中有374例(94.9％)感染发生在孕中期和孕晚期；孕早、中、晚期患者均表现为发热及伴有呼吸道症状,但孕中、晚期患者更易出现咳血痰、呼吸困难、合并肺炎；孕中期和晚期使用机械通气的总体比例(44.7％,167/374)显著高于孕早期(3/20)；77例患者死亡,其中72.7％ (56/77)死于孕晚期；52.5％(207/394)患者起病后终止妊娠,其中57.0％(118/207)孕周＜37周；有29.0％(60/207)的胎儿死亡.结论妊娠合并甲型H1N1流感的孕中期和孕晚期患者病情较重,孕妇及其胎儿病死率高.
목적 분석불동잉기중증갑형H1N1류감환자적림상특정.방법 회고성수집2009년9월1일지12월31일중국대륙지구27개성시종합의원혹전염병의원수치적394례중증혹위중증갑형H1N1류감잉부적림상자료,비교잉조、중、만기환자적림상특점.학진병례정의위갑형H1N1류감병독핵산검측양성,병차부합갑형H1N1류감중증화위중증적진단표준.기우각변량유완정기록적병례수래계산각변량수거백분비.결과 394례환자중유374례(94.9％)감염발생재잉중기화잉만기；잉조、중、만기환자균표현위발열급반유호흡도증상,단잉중、만기환자경역출현해혈담、호흡곤난、합병폐염；잉중기화만기사용궤계통기적총체비례(44.7％,167/374)현저고우잉조기(3/20)；77례환자사망,기중72.7％ (56/77)사우잉만기；52.5％(207/394)환자기병후종지임신,기중57.0％(118/207)잉주＜37주；유29.0％(60/207)적태인사망.결론 임신합병갑형H1N1류감적잉중기화잉만기환자병정교중,잉부급기태인병사솔고.
Objective To explore the disease course and outcomes of severe or critical pregnant women with 2009 pandemic H1N1 (pH1N1) infection in China.Methods A retrospective observational study was conducted for 394 severe or critical pregnant women with pH1 N1 influenza admitted into hospital in 27 Chinese provinces from September 1,2009 to December 31,2009.Their clinical features in different trimesters were analyzed.The viral infection of pH1N1 was verified by real-time reverse transcription (rRT)-PCR.Severe and critical cases were defined according to the 2009 H1 N1 clinical guidelines.Results Among them,374 (94.9％) were infected in the second or third trimester.Fever and cough were the most common symptoms in all trimesters.However,hemoptysis,dyspnea and associated pneumonia were likely to occur in the second or third trimester.The ratio of required mechanical ventilation in the second or third trimester (44.7％,167/374) was significantly higher than that in the first trimester (3/20).Among 77 mortality cases,72.7％ (56/77) died in the third trimester.Pregnancy was terminated after the onset of pH1N1 symptoms in 52.5％ (207/394) pregnant women.And 57.0％ (118/207) of them had delivery ＜ 37 weeks and 29.0％ (60/207) fetuses deceased.Conclusion A clinician should be on a high alert for pH1N1 infection in pregnant women,particularly in the second or third trimester.