中华传染病杂志
中華傳染病雜誌
중화전염병잡지
CHINESE JOURNAL OF INFECTIOUS DISEASES
2009年
10期
582-585
,共4页
刘映霞%杨大国%谢靖婧%李慧涓%刘艳%施霞%孟娟%张培泽%周泱%傅佳鹏%陈莉%李建明%兰剑锋%曾丽娇%周伯平
劉映霞%楊大國%謝靖婧%李慧涓%劉豔%施霞%孟娟%張培澤%週泱%傅佳鵬%陳莉%李建明%蘭劍鋒%曾麗嬌%週伯平
류영하%양대국%사정청%리혜연%류염%시하%맹연%장배택%주앙%부가붕%진리%리건명%란검봉%증려교%주백평
流感病毒A型%H1N1亚型%流感%人%流行病学%抗病毒药
流感病毒A型%H1N1亞型%流感%人%流行病學%抗病毒藥
류감병독A형%H1N1아형%류감%인%류행병학%항병독약
Influenza A virus%H1N1 subtype%Influenza%human%Epidemiology%Antiviral agents
目的 了解2009年深圳市收治的30例甲型H1N1流行性感冒(流感)确诊病例的流行病学和临床特点.方法 30例患者均经2次鼻拭子、咽拭子甲型H1N1流感病毒核酸检测阳性(RT-PCR法),此后每天检测病毒核酸直至连续2 d均阴性.第1次病毒核酸检测阳性后立即开始奥司他韦(商品名为达菲)或"中药Ⅰ号"抗病毒治疗,5 d为一疗程.收集患者流行病学、临床和一般实验室资料.统计学处理采用t检验.结果 29例患者为输入性病例,另1例为二代病例,系7个月女婴.发病平均年龄(20.42±12.59)岁,离开疫区至发病的平均时间为(53.33±53.08)h,其中2例离开疫区超过8 d才发病,其密切接触人群中发现1例隐性感染者.30例患者均有发热,平均最高体温(38.40±0.80)℃.其他临床症状依次为咳嗽17例(56.7%)、流涕9例(30.0%)、咽痛9例(30.0%)、头痛7例(23.3%)、鼻塞2例(6.7%)、肌肉酸痛1例(3.3%).22例患者在抗病毒治疗5d内病毒核酸转阴,8例在抗病毒治疗第6天或以后病毒核酸转阴.21例在病程7 d内病毒核酸转阴,9例在起病后病毒核酸阳性持续8 d或以上,后者较前者中性粒细胞计数明显下降,分别为(1.47±1.03)×109/L和(2.69±1.63)×109/L(t=2.06,P=0.048),血常规异常持续时间也明显延长,分别为(2.78±2.49)d和(0.71±1.31)d,差异有统计学意义(t=2.34,P:0.006).结论 甲型H1N1流感发病年龄偏低,临床症状不严重.部分病例潜伏期可能超过7 d,病程7 d或抗病毒治疗5 d后仍有可能检出病毒,存在亚临床隐性感染的可能.血常规变化与病毒核酸阳性的持续时间存在一定关系.
目的 瞭解2009年深圳市收治的30例甲型H1N1流行性感冒(流感)確診病例的流行病學和臨床特點.方法 30例患者均經2次鼻拭子、嚥拭子甲型H1N1流感病毒覈痠檢測暘性(RT-PCR法),此後每天檢測病毒覈痠直至連續2 d均陰性.第1次病毒覈痠檢測暘性後立即開始奧司他韋(商品名為達菲)或"中藥Ⅰ號"抗病毒治療,5 d為一療程.收集患者流行病學、臨床和一般實驗室資料.統計學處理採用t檢驗.結果 29例患者為輸入性病例,另1例為二代病例,繫7箇月女嬰.髮病平均年齡(20.42±12.59)歲,離開疫區至髮病的平均時間為(53.33±53.08)h,其中2例離開疫區超過8 d纔髮病,其密切接觸人群中髮現1例隱性感染者.30例患者均有髮熱,平均最高體溫(38.40±0.80)℃.其他臨床癥狀依次為咳嗽17例(56.7%)、流涕9例(30.0%)、嚥痛9例(30.0%)、頭痛7例(23.3%)、鼻塞2例(6.7%)、肌肉痠痛1例(3.3%).22例患者在抗病毒治療5d內病毒覈痠轉陰,8例在抗病毒治療第6天或以後病毒覈痠轉陰.21例在病程7 d內病毒覈痠轉陰,9例在起病後病毒覈痠暘性持續8 d或以上,後者較前者中性粒細胞計數明顯下降,分彆為(1.47±1.03)×109/L和(2.69±1.63)×109/L(t=2.06,P=0.048),血常規異常持續時間也明顯延長,分彆為(2.78±2.49)d和(0.71±1.31)d,差異有統計學意義(t=2.34,P:0.006).結論 甲型H1N1流感髮病年齡偏低,臨床癥狀不嚴重.部分病例潛伏期可能超過7 d,病程7 d或抗病毒治療5 d後仍有可能檢齣病毒,存在亞臨床隱性感染的可能.血常規變化與病毒覈痠暘性的持續時間存在一定關繫.
목적 료해2009년심수시수치적30례갑형H1N1류행성감모(류감)학진병례적류행병학화림상특점.방법 30례환자균경2차비식자、인식자갑형H1N1류감병독핵산검측양성(RT-PCR법),차후매천검측병독핵산직지련속2 d균음성.제1차병독핵산검측양성후립즉개시오사타위(상품명위체비)혹"중약Ⅰ호"항병독치료,5 d위일료정.수집환자류행병학、림상화일반실험실자료.통계학처리채용t검험.결과 29례환자위수입성병례,령1례위이대병례,계7개월녀영.발병평균년령(20.42±12.59)세,리개역구지발병적평균시간위(53.33±53.08)h,기중2례리개역구초과8 d재발병,기밀절접촉인군중발현1례은성감염자.30례환자균유발열,평균최고체온(38.40±0.80)℃.기타림상증상의차위해수17례(56.7%)、류체9례(30.0%)、인통9례(30.0%)、두통7례(23.3%)、비새2례(6.7%)、기육산통1례(3.3%).22례환자재항병독치료5d내병독핵산전음,8례재항병독치료제6천혹이후병독핵산전음.21례재병정7 d내병독핵산전음,9례재기병후병독핵산양성지속8 d혹이상,후자교전자중성립세포계수명현하강,분별위(1.47±1.03)×109/L화(2.69±1.63)×109/L(t=2.06,P=0.048),혈상규이상지속시간야명현연장,분별위(2.78±2.49)d화(0.71±1.31)d,차이유통계학의의(t=2.34,P:0.006).결론 갑형H1N1류감발병년령편저,림상증상불엄중.부분병례잠복기가능초과7 d,병정7 d혹항병독치료5 d후잉유가능검출병독,존재아림상은성감염적가능.혈상규변화여병독핵산양성적지속시간존재일정관계.
Objective To investigate the epidemiology and clinical manifestation of 30 confirmed cases of influenza A(H1N1)in Shenzhen city in 2009.Methods Testing positive for influenza A (H1N1)virus nucleic acid by reverse transcription polymerase chain reaction(RT-PCR)with nose swabs and pharynx swabs two times were showed in 30 patients.Thereafter,the virus nucleic acid was detected once per day until the results were negative on two consecutive days.The antiviral treatment with oseltamivir or the Chinese medicine I started immediately after testing positive by RTPCR at the first time and tasted for 5 days.The epidemiological,clinical and laboratory data of all patients were collected.Data were analyzed by t test.Results Twenty-nine patients were imported cases.The remaining one was secondary case who was a 7-month old female infant.The mean age of all patients was(20.42±12.59)years old.The time from onset to leaving epidemic areas was(53.33±53.08)hours.There were two patients who left the epidemic areas for over 8 days before the onset of illness.One recessive infected case was found in the close contacts of the confirmed cases.The study reported that all patients had fevers.The mean highest body temperature was(38.40±0.80)℃.Other symptoms in turn were 17 with coughing(56.7%),9 with snivel(30.0%),9 with sore throat (30.0%),7 with headache(23.3%),2 with nasal obstruction(6.7%)and 1 with muscle ache (3.3%).Seventy-three point three percent(22/30)of patients whose virus nucleic acid turned negative in 5 days of antiviral treatments,and 8 turned negative on day 6 or after 6 days of treatment.Seventy percent(21/30)of patients whose virus turned negative in 7 days of duration,the other 30.0%(9/30)of cases whose virus were still positive after 7 days of duration.Comparing with the former,the neutrophilic granulocyte count of the latter decreased significantly[(1.47±1.03)×109/L vs(2.69±1.63)×109/L,t = 2.06,P= 0.048].The days of abnormal hemogram of the latter was prolonged obviously[(2.78±2.49)d vs(0.71±1.31)d,t=2.34,P=0.006].Conclusions The age of onset appears young and clinical manifestations appear slight in the patients with influenza A(H1N1).The incubation period of some cases probably exceeds 7 days,and it is possible to detect.virus after 7 days of duration or 5 days of antiviral treatment.Subclinical recessive infection could occur.The change of hemogram is correlated with the duration of testing positive of virus nucleic acid.
