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目的探讨甲型流感(甲流)病毒抗原、白细胞总数(WBC)、中性粒细胞(Neu)、淋巴细胞(Lym)、嗜酸性粒细胞(Eos)、血小板(PLT)、C反应蛋白(CRP)、降钙素(PCT)等感染性指标的变化及其对H7N9禽流感患者的临床价值,为人感染H7N9禽流感病的诊断、治疗及预后判断提供实验室依据。方法 9例确诊为H7N9禽流感患者作为H7N9组,382例已排除H7N9禽流感但甲流抗原检测阳性患者作为普通流感组,400例健康体检人员作为正常对照组,并根据患者康复情况再将H7N9组分为轻症组(5例,均为儿童)和重症组(4例)。比较各组感染性指标的变化。结果与正常对照组比较,H7N9组和普通流感组的甲流病毒抗原阳性率(77.8%、100.0%)和CRP均升高,Lym、Eos、PLT计数均明显下降,差异均有统计学意义(P<0.05)。与普通流感组比较,H7N9组CRP升高,差异有统计学意义(P<0.05)。与轻症组比较,重症组WBC、Lym、Eos和PLT计数明显下降,CRP明显升高,差异均有统计学意义(P<0.05)。结论甲流病毒抗原、WBC、Lym、Eos、PLT、CRP水平对H7N9禽流感患者临床诊断具有一定的参考意义,对H7N9禽流感患者的诊断和区分轻、重症及预后判断有一定的提示作用。
Objective To investigate the clinical significance of influenza A virus antigen, WBC, Neu, Lym, Eos, platelet (PLT) and C-reactive protein ), Calcitonin (PCT), and their clinical value in the diagnosis of H7N9 avian influenza and provide a laboratory evidence for the diagnosis and treatment of H7N9 avian influenza. Methods Nine patients diagnosed as H7N9 bird flu as H7N9 group, 382 H7N9 bird flu were excluded but positive for influenza A antigen were detected as normal flu group and 400 healthy people as normal control group, and H7N9 The patients were divided into mild group (5 cases, both children) and severe group (4 cases). The changes of infectious index in each group were compared. Results Compared with the normal control group, the positive rate of influenza A virus antigen (77.8%, 100.0%) and CRP in H7N9 group and normal flu group were all increased, and the counts of Lym, Eos and PLT were significantly decreased P <0.05). Compared with the normal flu group, CRP increased in H7N9 group, with significant difference (P <0.05). Compared with the mild group, the counts of WBC, Lym, Eos and PLT in the severe group were significantly decreased, and the CRP was significantly increased, the difference was statistically significant (P <0.05). Conclusion The prevalence of influenza A virus, WBC, Lym, Eos, PLT and CRP may be useful for the clinical diagnosis of H7N9 avian influenza patients. It is helpful to diagnose and differentiate H7N9 bird flu from mild to severe cases and prognosis.