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目的对比分析宁波地区轻、重症甲型H1N1流感的流行病学和临床特征。方法回顾分析宁波市传染病院2009年7月1日至2009年12月31日收治的204例患者的临床资料,其中轻症52例,重症152例。结果两组患者均以本地户籍者居多,均无明确接触史。成人患者以青年人群为主,但重症者多见于小儿、老年、伴有肥胖和相关代谢综合征、孕妇或剖宫产术后人群。职业分布均以中青年职员和学生为主。发热、咳嗽、咳痰为其突出及特征表现,两组高热(≥39℃)患者的构成比及发热持续时间比较差异有统计学意义;重症患儿的平均最高体温、流涕及消化道症状、咽部充血及扁桃体肿大均高于重症成人患者。轻症患者无并发症;重症患者并发不同程度肺炎或支气管肺炎,小儿以支气管肺炎为主,成人以肺炎为主。两组患者肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、肝功能及白细胞(WBC)升高异常率比较差异均有统计学意义。重症患者平均住院时间较长。结论重症病例仍以发热及呼吸道改变为主,并发症以支气管肺炎、肺炎、心肌及肝功能损害为主,成人及小儿临床表现不一致。
Objective To compare and analyze the epidemiological and clinical features of influenza A and H1N1 in Ningbo. Methods The clinical data of 204 patients admitted to Ningbo Infectious Hospital from July 1, 2009 to December 31, 2009 were retrospectively analyzed. Among them, 52 cases were mild and 152 cases were severe. Results Both groups of patients were mostly local domicile, no clear history of exposure. Adult patients are mainly young people, but severe cases are more common in children, the elderly, with obesity and related metabolic syndrome, pregnant women or people after cesarean section. Occupation distribution are young and middle-aged staff and students. Fever, cough and expectoration were the prominent and characteristic features. There were significant differences in the constituent ratio and the duration of fever between the two groups with high fever (≥39 ℃). The mean body temperature, runny nose and digestive symptoms , Pharyngeal hyperemia and tonsil enlargement were higher than in severe adult patients. Mild patients without complications; severe patients complicated with varying degrees of pneumonia or bronchial pneumonia, bronchial pneumonia in children-based, adult-based pneumonia. There were significant differences in abnormal rates of creatine kinase (CK), creatine kinase (CK-MB), lactate dehydrogenase (LDH), liver function and WBC in both groups. The average length of stay in critically ill patients is longer. Conclusions Severe cases are still mainly fever and respiratory changes, complications of bronchial pneumonia, pneumonia, myocardial damage and liver function-based, adult and pediatric clinical manifestations are inconsistent.