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目的探讨甲型H1N1流感患儿的流行特点及临床特征,为甲型H1N1流感的诊疗和预防提供依据。方法 以湖南省儿童医院2009年10月27日-2010年2月27日收治的105例实验室确诊甲型H1N1流感病例为研究对象,回顾性分析其流行病学和临床特征。结果1.105例甲型H1N1流感患儿以男性为主,高发年龄为0~5岁,大部分来自城镇,50.5%有接触史,90.5%患儿入院时间集中在11月、12月份。34例(32.4%)以其它疾病入院。2.临床表现无特异性。咳嗽、发热为其普遍症状,部分患儿出现呕吐、腹泻及头痛症状。24例(22.9%)患儿存在基础疾病。3.白细胞下降主要发生在婴儿;WBC升高主要见于1岁以上患儿。ESR、CRP、PCT等炎性指标及CK、AST、BAMS等酶学指标异常广泛。早期胸片改变较临床明显。4.重症及危重症病例占到71.5%。肺炎为最常见并发症,发生率为80.0%,呼吸衰竭为最严重并发症,发生率为18.1%。结论儿童甲型H1N1流感无特异表现,病情相对温和;但在部分儿童,特别是有基础病史者可表现为重症;门诊血常规、胸片检查有助于早期发现重症。
Objective To investigate the epidemiological characteristics and clinical features of children with influenza A (H1N1) and provide basis for the diagnosis, treatment and prevention of influenza A (H1N1). Methods A total of 105 laboratory confirmed cases of Influenza A (H1N1) in Hunan Children’s Hospital from October 27, 2009 to February 27, 2010 were enrolled in this study. The epidemiological and clinical features were retrospectively analyzed. Results 1.105 cases of children with influenza A (H1N1) were mainly male, with a high prevalence of 0-5 years. Most of them came from cities and towns, 50.5% had history of contact and 90.5% of children admitted to hospital in November and December. 34 cases (32.4%) were admitted to hospital with other diseases. 2 non-specific clinical manifestations. Cough, fever is its common symptoms, some children with vomiting, diarrhea and headache symptoms. Twenty-four patients (22.9%) had underlying disease. 3. Leukopenia occurs mainly in infants; WBC increased mainly seen in children over 1 year old. ESR, CRP, PCT and other inflammatory indicators and CK, AST, BAMS and other enzymatic indicators of abnormal wide range. Early changes in chest X-ray obvious clinical. Severe and critically ill cases accounted for 71.5%. Pneumonia was the most common complication, with an incidence of 80.0%. Respiratory failure was the most serious complication, with an incidence of 18.1%. Conclusions Children with influenza A (H1N1) have no specific symptoms and their disease is relatively mild. However, some children, especially those with basic medical history, may present with severe illness. Outpatient blood tests and chest radiography may help to find severe early symptoms.