摘要
目的探讨轻型与肺炎型H1N1甲型流感临床特点及实验室检查结果异同,为早期诊断肺炎型甲型流感提供依据。方法对承德市2009年9—12月经证实的206例甲型H1N1流感(全部)患者进行血常规、生化全项、胸部X线检查,疑为肺炎者进一步检查胸部CT。根据X线胸片有无片状阴影将全部患者分为轻型与肺炎型两组。结果肺炎组以0～7岁组和≥46岁组发病率最高,两组比较差异有统计学意义(P<0.05)。轻型组(19.9%)血白细胞总数低于正常人数百分比小于肺炎组(34.0%),差异有统计学意义(P=0.04),轻型组(77.6%)白细胞正常人数百分比大于肺炎组(50.0%),差异有统计学意义(P<0.001)。白细胞分类:肺炎组(60.0%)中性粒细胞比率高于正常人数百分比大于轻型组(42.9%),差异有统计学意义(P=0.036);肺炎组(28.0%)单核细胞比率低于正常人数百分比大于轻型组(5.1%),差异有统计学意义(P<0.001)。肺炎组(22.0%)血小板低于正常人数百分比大于轻型组(4.5%),差异有统计学意义(P=0.001)。肺炎组(20.0%)血红蛋白低于正常人数百分比大于轻型组(1.3%),差异有统计学意义(P<0.001)。血电解质:肺炎组血钾(K+)、钠(Na+)、氯(Cl-)低于正常人数百分比超过轻型组,差异有统计学意义(P<0.05)。血清酶学检查发现除了肌酸激酶(CK)以外,肺炎组血清酶学高于正常人数比率均较轻型组高,差异有统计学意义(P<0.05)。结论甲型H1N1发病年龄以8～45岁年龄组人群为高,但肺炎型患者则以0～7岁和≥46岁年龄组为多,性别对病情轻重可能没有影响。白细胞总数低于正常、中性粒细胞比率高于正常提示易患肺炎型H1N1流感。单核细胞比率、血小板计数、血红蛋白低于正常易患肺炎型H1N1流感。血清谷丙转氨酶、谷草转氨酶、肌酸激酶同工酶、乳酸脱氢酶、碱性磷酸酶高于正常,提示易出现肺炎型H1N1流感。
Objective To investigate the difference in clinical and laboratory results between patients with mild and pneumonic H1N1 infection so as to provide a basis for an early diagnosis of pneumonic H1N1 infection. Methods Hematologic laboratory and thoracic radiograph studies were performed in all 206 patients with H1N1 proved by RT-PCR（admitted from September to December 2009） in Chengde City.A computed tomography c（CT） scan of the chest was examined for the suspected patients with pneumonia.All the patients were divided into 2 groups based on whether there was the lamellar shadow in the thoracic radiograph. Results（1） The incidence of pneumonic H1N1 was higher in patients aged 0～7 and ≥46（P0.05）.The percentage of total leukocyte countthe normal was lower in the mild group than in the pneumonic group（19.9% vs 34.0%,P=0.04）,and the percentage of normal leukocyte count was higher in the mild group than in the pneumonic group（77.6% vs 50.0%,P0.001）.The percentage of neutrophil countthe normal was higher in the pneumonic group than in the mild group（60.0% vs 42.9%,P=0.036）,and the percentage of monocyte countthe normal was higher in the pneumonic group than in the mild group（28.0% vs 5.1%,P0.001）.The percentage of platelets countthe normal was higher in the pneumonic group than in the mild group（22.0% vs 4.5%,P=0.001）.The percentage of hemoglobinthe normal was higher in the pneumonic group than in the mild group（20.0% vs 1.3%,P0.001）,The percentages of serum ions K＋,Na＋,Cl＋the normal were higher in the pneumonic group than in the mild group（P0.05）.The percentages of sero-enzymesthe normal,with a exception of CK,were higher in the pneumonic group than in the mild group（P0.05）. Conclusion The H1N1influenza is found more frequently in population aged from 8 to 45,but the pneumonic type in people 0-7 years or ≥46 years.The sex might not be associated with the severity of the disease.The decrease of total leukocyte count and the increase of the neutrophil percentage i
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第13期1479-1482,共4页
Chinese General Practice
