摘要
目的分析免疫抑制住院患者流感病毒感染的临床特征及抗病毒药物治疗情况。方法回顾性分析2015年11月至2022年3月北京大学人民医院甲型或乙型流感病毒核酸阳性的273例住院患者的临床资料,其中123例为免疫抑制患者,150例为非免疫抑制患者。分析免疫抑制流感患者的临床特征及抗病毒治疗情况。应用SPSS 22.0软件对数据进行统计学分析。结果免疫抑制患者中,主要免疫抑制类型为恶性肿瘤化疗(61.8%,76/123)和造血干细胞移植(24.4%,30/123)。主要临床表现是发热(93.5%,115/123)和咳嗽(41.5%,51/123)。22.8%(28/123)患者合并其他感染,43.9%(54/123)患者合并并发症。与非免疫抑制流感患者相比,免疫抑制流感患者合并感染及并发症比例更高(χ^(2)=9.365和7.496,P<0.01)。免疫抑制流感患者抗病毒药物联合应用较单药应用未缩短热退时间、病毒转阴时间、住院时间及减少死亡(U/χ^(2)=312.5、356.0、749.5和0.185,P值均>0.05)。与未应用激素患者比较,免疫抑制流感患者应用激素未增加病死率(χ^(2)=2.508,P=0.113)。结论免疫抑制流感患者流感常见症状可能缺乏,及早进行流感病毒病原学检测仍是早期诊断的重要手段。免疫抑制流感患者合并感染和并发症更多,且不能受益于抗病毒药物的联合应用。
Objective To analyse the clinical characteristics and antiviral therapy in immunosuppressed hospitalized patients with influenza.Methods The clinical data of 273 patients with positive influenza A or B virus nucleic acid admitted in Peking University People’s Hospital from November 2015 to March 2022 were retrospectively analyzed.Among them,123 were immunosuppressed and 150 were non-immunosuppressed.The clinical characteristics and antiviral therapy in immunosuppressed patients with influenza were analyzed.SPSS 22.0 software was used to analyze the data.Results Chemotherapy for malignancies was the most common cause of immunosuppression(61.8%,76/123),followed by haemopoietic stem cell transplantation(24.4%,30/123).The common symptoms were fever(93.5%,115/123)and cough(41.5%,51/123).The proportions of co-infections(22.8%,28/123)and complications(43.9%,54/123)in immunosuppressed hospitalized patients were higher than those in non-immunosuppressed patients(χ^(2)=9.365 and 7.496,both P<0.01).Compared with single drug therapy,combination of antiviral drugs did not shorten the fever time,negative conversion time of virus nucleic acid and the length of hospital stay,and reduce the death(U/χ^(2)=312.5,356.0,749.5 and 0.185,all P>0.05).Compared to patients without corticosteroids use,the use of corticosteroids did not increase mortality in immunosuppressed patients(χ^(2)=2.508,P=0.113).Conclusions Classical symptoms may be absent in immunosuppressed patients with influenza,and early detection of influenza virus is still an important means of early diagnosis.Co-infections and complications are more common in immunosuppressed influenza patients.Immunosuppressed influenza patients did not benefit from the combination of antiviral therapy.
作者
刘雅芬
王越
王艳欣
买欢
陈媛媛
张一帆
刘百怡
刘义思
季颖
丛旭
高燕
Liu Yafen;Wang Yue;Wang Yanxin;Mai Huan;Chen Yuanyuan;Zhang Yifan;Liu Baiyi;Liu Yisi;Ji Ying;Cong Xu;Gao Yan(Department of Infectious Diseases,Peking University People’s Hospital,Beijing 100044,China;Peking University Hepatology Institute,Peking University People’s Hospital,Beijing 100044,China)
出处
《中华临床感染病杂志》
CAS
CSCD
2023年第2期120-127,共8页
Chinese Journal of Clinical Infectious Diseases
基金
国家自然科学基金(81541139)。
关键词
流行性感冒
免疫抑制
恶性肿瘤
造血干细胞移植
抗病毒治疗
Influenza
Immunosuppression
Malignancy
Haemopoietic stem cell transplants
Antiviral therapy
