深圳市龙华区甲型H1N1流行性感冒流行病学调查及特征研究
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摘要
目的了解深圳市龙华区甲型H1N1流行性感冒流行病学及临床特征,提高临床医师对该病的认识。方法对深圳市龙华区2016年5月～2017年3月确诊的甲型H1N1流行性感冒患者进行回顾性分析。结果本组患者156例,男95例,女61例,年龄16～72岁,平均年龄(49.8±1.5)岁,发病高峰期为2016年11～12月。临床上主要表现为流感症状,包括咳嗽、发热、鼻塞、头痛及全身酸痛等,咽部充血50例,咳嗽30例,发热89例,扁桃体肿大59例,咳痰15例等。91.45%患者外周血白细胞总数偏低或正常,63.78%患者中性粒细胞总数大于正常值,45.13%患者CD4~+T淋巴细胞低于正常下限水平。甲型H1N1流行性感冒患者的咽拭子标本在发热时检测为阳性,经胸部CT检查,患者表现为胸膜炎、肺炎、肺纹理增粗等;全部患者均痊愈出院。结论甲型H1N1流行性感冒传染性较强,其流行病学及临床特征与普通季节性流感相似,深圳市龙华区甲型H1N1流行性感冒患者以中年群体为主,病情较轻,轻型患者可无需奥司他韦抗病毒治疗,使用三九感冒灵、双黄连等中药制剂抗病毒治疗可以治愈。
Objective To understand the epidemiological and clinical characteristics of A H1 N1 influenza in Longhua district of Shenzhen and to improve the understanding of clinicians. Methods Patients who were diagnosed as A H1 N1 influenza Longhua district of Shenzhen from May 2016 to March 2017 were retrospectively analyzed.Results There were 156 patients in this study, including 95 males and 61 females aged 16 to 72 years old, with an average age of(49.8±1.5) years. The peak incidence period of the disease was from November 2016 to December2016. The main clinical manifestations were flu symptoms, including cough, fever, nasal congestion, headache and body aches. There were 50 cases of pharyngeal congestion, 30 cases of cough, 89 cases of fever, 59 cases of antiadoncus and 15 cases of cough. The total number of peripheral blood leukocytes was low or normal in 91.45%patients, the total number of neutrophils was larger than normal value in 63.78% patients and the CD4~+ T lymphocytes of 45.13% patients were lower than the normal lower limit. The throat swab specimens of patients with A H1 N1 influenza were tested positive during fever. After chest CT examination, the patients showed pleurisy, pneumonia, thickening of lung texture, etc. All patients were cured and discharged from hospital. Conclusion A H1 N1 influenza is highly contagious and its epidemiology and clinical characteristics are similar to those of ordinary seasonal influenza. The patients with A H1 N1 influenza in Longhua district of Shenzhen are mainly middle-aged groups and the condition is mild. Patients with mild A H1 N1 influenza may not need treatment with oseltamivir. It can be cured by antiviral therapy of 999 Ganmaoling granules,double coptis and other traditional Chinese medicine preparations.
Objective To understand the epidemiological and clinical characteristics of A H1 N1 influenza in Longhua district of Shenzhen and to improve the understanding of clinicians. Methods Patients who were diagnosed as A H1 N1 influenza Longhua district of Shenzhen from May 2016 to March 2017 were retrospectively analyzed.Results There were 156 patients in this study, including 95 males and 61 females aged 16 to 72 years old, with an average age of(49.8±1.5) years. The peak incidence period of the disease was from November 2016 to December2016. The main clinical manifestations were flu symptoms, including cough, fever, nasal congestion, headache and body aches. There were 50 cases of pharyngeal congestion, 30 cases of cough, 89 cases of fever, 59 cases of antiadoncus and 15 cases of cough. The total number of peripheral blood leukocytes was low or normal in 91.45%patients, the total number of neutrophils was larger than normal value in 63.78% patients and the CD4~+ T lymphocytes of 45.13% patients were lower than the normal lower limit. The throat swab specimens of patients with A H1 N1 influenza were tested positive during fever. After chest CT examination, the patients showed pleurisy, pneumonia, thickening of lung texture, etc. All patients were cured and discharged from hospital. Conclusion A H1 N1 influenza is highly contagious and its epidemiology and clinical characteristics are similar to those of ordinary seasonal influenza. The patients with A H1 N1 influenza in Longhua district of Shenzhen are mainly middle-aged groups and the condition is mild. Patients with mild A H1 N1 influenza may not need treatment with oseltamivir. It can be cured by antiviral therapy of 999 Ganmaoling granules,double coptis and other traditional Chinese medicine preparations.
引文
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[15]王佳佳,谢洋,李建生.中医药防治急性病毒性呼吸道传染病的现状与思考[J].中医学报,2015,30(8):1095-1098.
[16]李迎飞,王艳荣,王险峰. 96例儿童甲型H1N1流感患者的临床分析[J].中国医药科学,2017,7(4):105-108.
[2]康欣.儿童甲型H1N1流行性感冒四例的护理要点[J].继续医学教育,2016,30(4):135-136.
[3]车飞虎,崔大伟,孙海燕,等.2013-2015年浙江地区新型甲型H1N1流行性感冒的流行病学和临床特征调查[J].临床检验杂志,2016,34(4):307-311.
[4]刘福英.贯众清热灵喷雾剂治疗甲型H1N1流行性感冒临床观察[J].新中医,2016,48(2):37-38.
[5]余好,许少坚,任燕,等.深圳市龙华区2016年手足口病流行病学和病原学特征[J].中国热带医学,2017,17(4):402-404.
[6]金涛,王双英,彭健,等.一起甲型H1N1流行性感冒疫苗接种诉讼案的探讨[J].中国疫苗和免疫,2015,21(5):593,588.
[7]白本海.开封市某小学一起甲型H1N1流行性感冒暴发疫情分析[J].河南预防医学杂志,2015,26(5):420-421,433.
[8]白江涛,许少坚,任燕,等. 2015-2016年深圳市龙华区手足口病流行病学和病原学特征[J].中华疾病控制杂志, 2017,21(7):92-96.
[9]赵丹,苏志磊,于萍,等.青岛地区2012-2014年甲型H1N1流感病毒基因特征[J].中国公共卫生,2016,32(8):1096-1100.
[10]李伟.甲型H1N1流感防治进展[J].首都食品与医药,2015,22(12):18.
[11]张晓雷,马家驹,蔡永登,等.2009年以来流行性感冒的中医药防治研究概况[J].山东中医杂志,2017,36(8):717-720.
[12]敬岳.流行性感冒中医证候学特征横断面调查及随访研究[D].北京:北京中医药大学,2017.
[13]刘晓婷.黄芩苷对流感病毒H1N1感染A549细胞的作用及免疫调控机制的研究[D].北京:北京中医药大学,2016.
[14]徐喜卿,李顺平.我国甲型H1N1流感疫苗免疫效果评估系统综述[J].实用预防医学,2016,23(4):506-509.
[15]王佳佳,谢洋,李建生.中医药防治急性病毒性呼吸道传染病的现状与思考[J].中医学报,2015,30(8):1095-1098.
[16]李迎飞,王艳荣,王险峰. 96例儿童甲型H1N1流感患者的临床分析[J].中国医药科学,2017,7(4):105-108.