摘要
目的:分析3种流感病毒(H1N1、H3N2、乙型)的流行病学特点及其感染患者的血常规结果,为类流感患者的临床预防、诊断和治疗提供新的思路和依据。方法:统计2010年1月至2012年12月在本院发热门诊就诊,且经病毒核酸检测证实的421例H1N1、H3N2及乙型流感患者,同时采集其手指末梢血进行血常规检查,用SPSS 19.0统计软件对其流感病毒流行趋势进行分析。结果:H1N1、H3N2、乙型流感病毒的暴发没有特定规律,但有阶段性。421例类流感患者的血常规分析中,白细胞总数正常者311例(73.87%)、增高者86例(20.43%);中性粒细胞百分比增高者313例(74.35%);淋巴细胞百分比降低者274例(20.43%)。3种流感患者的血常规结果经t检验后提示,H1N1与H3N2流感患者的白细胞总数、中性粒细胞百分比及淋巴细胞百分比间均无统计学差异(P>0.05),而H1N1及H3N2与乙型流感患者间的白细胞总数、中性粒细胞百分比及淋巴细胞百分比都存在统计学差异(P<0.01)。结论:H1N1、H3N2、乙型流感病毒的爆发无规律,但可在一定阶段流行,因此对类流感患者的监测要坚持全年并严密防范。流感病毒阳性患者主要以白细胞总数正常、中性粒细胞百分比增高及淋巴细胞百分比降低为主,但H1N1、H3N2流感患者比乙型流感患者的白细胞总数、中性粒细胞百分比要高,而其淋巴细胞百分比则相对乙型流感患者要低。故对于血常规检测结果与流感病毒感染的通常血象变化不符,但临床高度怀疑为流感病毒感染者,在抗菌治疗效果不明显时,应考虑作咽、鼻拭子病毒核酸检测,以进一步确诊。
Objective： To analyze the epidemiological characteristics and results of routine blood test of H1N1, H3N2, and type B influenza patients for providing new insights to the prevention,diagnosis and treatment of influenza. Methods： A total of 1 276 Out Patient Department patients with influenza-like illness （ILS） from Jan. 2010 to Dec.2012 were collected, and of them 421 patients were confirmed by real-time PCR to be suffered from NIH1, H3N2 or type B influenza. The epidemiological trends of these three types of influenza were analyzed by SPSS 19.0 software, and the results of routine blood test were analyzed statistically by X2 test and t test. Results： The outbreaks of these 3 types of influenza had no specific conformity but had seasonal periodicity. Analysis of routine blood test showed that WBC count was normal in 311 patients （73.87%）and increased in 86 patients （20.43%）; 313 patients （74.35%） had elevation of neutrophils; 274 patients （20.43%） had reduction of lymphocytes, t test analysis showed that WBC count, percentages of neutrophils and lymphocytes were not significantly different between patients with H1N1 and H3N2 influenza （P〉0.05）, however, significant differences were found between patients with H1N1,H3N2 influenza and type B influenza （P〈0.01）. Conclusions： The outbreaks of H1N1, H3N2, and type B influenza have no specific conformity but with seasonal periodicity. In general, WBC count is normal percentage of neutrophils is increased and percentage of lymphocytes was decreased in influenza patients, however, WBC count and percentage of neutrophils are somewhat higher and percentage of lymphocytes is somewhat lower in H1N1 and H3N2 influenza than in type B influenza. Therefore, for patients with routine blood test not meeting the usual changes in influenza, but are highly suspected of having influenza and with no response to antibacterial agents, the detection of viral nuclei acid via throat and nasal swabs should be considered to establish the diagnosis.
出处
《诊断学理论与实践》
2013年第4期452-456,共5页
Journal of Diagnostics Concepts & Practice
关键词
类流感
流感
流感病毒甲型H1N1
血常规检测
Influenza-like illness
Influenza
Influenza virus, H1N1 subtype
Routine blood test
作者简介
通讯作者：李岚1120350@rjh．com．cn
