标题：人感染H7N9禽流感六例流行病学及临床特征分析

      作者：童学成，张燕萍，徐天敏    (常州市第三人民医院感染科，江苏 常州 213001)

      卷次： 2018年29卷16期

      【摘要】 目的 分析人感染H7N9禽流感患者的临床特点及流行病学特征。方法 采用回顾性研究方法，分析2016年12月至2017年1月常州市第三人民医院收治的6例感染H7N9禽流感患者的临床资料。结果 6例患者中男性4例，女性2例，年龄平均(51±15.27)岁，3例(50%)存在基础疾病；所有患者发病前均有活禽接触史或活禽市场逗留史；临床以发热、咳嗽、咯痰、胸闷、肌肉酸痛、腹泻为主要表现，3例患者出现急性呼吸窘迫综合征(ARDS)；实验室检查以外周血白细胞、淋巴细胞计数降低和心肌酶升高为特点，胸部CT表现为双肺磨玻璃样渗出性病变，病灶迅速进展，出现广泛肺实变；经积极抗病毒、对症等治疗，6例患者中5例治愈，1例死亡。结论 人感染H7N9禽流感容易出现重症肺炎，早期诊断，尽早抗病毒治疗，可减轻病情，降低死亡率。
      【关键词】 H7N9禽流感；流行病学特征；临床特征
      【中图分类号】 R511.7 【文献标识码】 A 【文章编号】 1003—6350（2018）16—2270—04

Epidemiological and clinical characteristics of human infection with H7N9 avian influenza: a report of 6 cases.TONG Xue-cheng, ZHANG Yan-ping, XU Tian-min.
Department of Infectious Diseases, the Third People's Hospital ofChangzhou, Jiangsu 213001, Jiangsu, CHINA
【Abstract】 Objective To analyze the main clinical and epidemiological features of human infection withH7N9 avian influenza. Methods A retrospective study was conducted to analyze the clinical data of 6 patients in-fected with H7N9 avian influenza in the Third People's Hospital of Changzhou from December 2016 to January2017. Results Among the 6 patients with the average age of (51±15.27) years, there were 4 cases of males, and 2 cas-es of females, of which 3 cases had basic diseases. Before the onset of disease, all patients had live poultry contact histo-ry or had live poultry market stay history. Fever, cough, chest pain, muscles pain, diarrhea were the main symptoms, and3 cases of patients appeared acute respiratory distress syndrome (ARDS). The reduction of peripheral white blood cell(WBC) and lymphocyte (LC) count, and increase of myocardial enzyme were the features of clinical laboratory testChest CT showed lateral pulmonary groundglass exudative lesions, rapid progression to extensive pulmonary. After ac-tive antiviral and symptomatic treatment, 5 patients were cured, and 1 patient died. Conclusion Human infection withH7N9 avian influenza is prone to severe pneumonia. Early diagnosis and early antiviral therapy can relieve the diseaseand reduce mortality.
      【Key words】 H7N9 avian influenza; Epidemiological features; Clinical feature·论 著·doi:10.3969/j.issn.1003-6350.2018.16.014