CAJ | 학술논문

目的：通过对2009年6月1日-2009年12月8日北京佑安医院收治的191例（死亡8例）甲型 H1N1流感病毒感染确诊住院病例的分析，了解发病期间 H1N1病毒感染患者 H1N1病毒核酸及淋巴细胞百分比的变化趋势以及二者之间关系，以期为临床提供简单易掌握的诊断数据。方法用实时 RT-PCR 检测 H1N1病毒核酸及血常规，并对191例患者的临床资料进行回顾性分析。结果H1N1病毒感染患者的病毒核酸阳性率与淋巴细胞百分比呈强负相关性（r＝－0．950，P ＜0．001）；H1N1病毒感染且并发肺炎的患者 H1N1病毒核酸为阴性时其淋巴细胞百分数大于病毒核酸阳性时的淋巴细胞百分数（42．96±2．50＞31．63±3．03，P ＜0．01）；在发病前7天，随着发病天数的增加，肺纹理清晰的患者淋巴细胞百分数有平滑上升趋势，而肺纹理增粗和肺炎的患者的淋巴细胞百分数上升趋势呈巨齿样波动；8例死亡病例死亡前的淋巴细胞百分比均低于20％，并在5％-15％范围内无规律波动。结论甲型 H1N1病毒能引起淋巴细胞数量上的降低，患者淋巴细胞百分比的高低变化趋势在一定程度上预示病情的轻重，当淋巴细胞百分比持续小于20％，预示病情危重。
목적：통과대2009년6월1일-2009년12월8일북경우안의원수치적191례（사망8례）갑형 H1N1류감병독감염학진주원병례적분석，료해발병기간 H1N1병독감염환자 H1N1병독핵산급림파세포백분비적변화추세이급이자지간관계，이기위림상제공간단역장악적진단수거。방법용실시 RT-PCR 검측 H1N1병독핵산급혈상규，병대191례환자적림상자료진행회고성분석。결과H1N1병독감염환자적병독핵산양성솔여림파세포백분비정강부상관성（r＝－0．950，P ＜0．001）；H1N1병독감염차병발폐염적환자 H1N1병독핵산위음성시기림파세포백분수대우병독핵산양성시적림파세포백분수（42．96±2．50＞31．63±3．03，P ＜0．01）；재발병전7천，수착발병천수적증가，폐문리청석적환자림파세포백분수유평활상승추세，이폐문리증조화폐염적환자적림파세포백분수상승추세정거치양파동；8례사망병례사망전적림파세포백분비균저우20％，병재5％-15％범위내무규률파동。결론갑형 H1N1병독능인기림파세포수량상적강저，환자림파세포백분비적고저변화추세재일정정도상예시병정적경중，당림파세포백분비지속소우20％，예시병정위중。
Objective To know correlativity between pandemic influenza A (H1N1)viral nucleic acid and lympho-cytes percentage (lymph %)of 191 patients with H1N1 viral infection treatment in YouAn hospital on 1 June-8 Decem-ber 2009 were useful to provide diagnosis data for doctors.Methods Specimens of H1N1 inpatients were tested by hae-mocyte counts and by real time RT-PCR (polymerase chain reaction).The same time,191 case histories were analyzed retrospectively.Results A strong negative correlativity between positive percent of nucleic acid and the lymph % was certified along with onset time extension(r=-0.950,P <0.001).of the H1N1 viral infection patients complicated by pneumonia was higher than those with negative percent of viral nucleic acid (42.96±2.50 VS 31.63±3.03,P <0.01). Within 7 days after onset,the lymph % of patients with clear pulmonary markings was elevation more smoothly than patients with pneumonia and thickness pulmonary markings.The lymph% of 8 died patients were persistently less 20%and fluctuation scope was at 50-15%.Conclusion The lymphocyte amount of patients with H1N1 influenza virus infec-tion were low resulting from invasion of H1N1 influenza virus.The change tendency of lymphocytes percentage indica-ted the patients’state of the illness.The less 20% persistently and the curve fluctuation of the lymph % imply that the pathogenetic condition was very severe.