20例H7N9禽流感患者的临床特点及预后分析

发布时间：2018-10-23 19:53

【摘要】：目的:本文通过20例确诊为H7N9禽流感患者的队列研究,为该疾病的诊治和预后分析提供更好的方法。方法:本文第一部分通过随访分析20例H7N9禽流感患者的起病特点、临床表现、治疗方案,总结该疾病的流行病学特点。第二部分通过分析H7N9禽流感患者的实验室数据及影像学检查,来阐述这些指标和预后的关系。结果:2016年12月到2017年3月,南昌大学第一附属医院共收入20例H7N9禽流感患者,平均年龄为60.1±11.7岁,其中60%的患者有明确的接触史,50%的患者有慢性基础疾病,最终死亡10例。通过分析这20例H7N9患者的检验检查结果,我们发现死亡组患者的血小板平均计数水平低,C反应蛋白(CRP)和降钙素原(PCT)水平高,多重耐药菌感染发生率极高,而生存组患者白细胞、血小板、淋巴细胞平均计数水平均较高,其中统计学分析发现血小板(PLT)、CRP和PCT的水平与患者的死亡率密切相关。结论:H7N9禽流感病毒致病性高,可迅速导致急性呼吸窘迫综合征(ARDS)的发生,甚至引起多器官功能障碍综合症(MODS),死亡率高,而PLT、CRP、PCT水平可以用来预测患者的临床结局。
[Abstract]:Objective: a cohort study of 20 patients with H7N9 avian influenza was conducted to provide a better method for the diagnosis, treatment and prognosis analysis of the disease. Methods: in the first part of this article, 20 patients with H7N9 avian influenza were analyzed for their onset, clinical manifestation and treatment plan, and the epidemiological characteristics of the disease were summarized. In the second part, the relationship between these indexes and prognosis was analyzed by analyzing the laboratory data and imaging examination of patients with H7N9 avian influenza. Results: from December 2016 to March 2017, the first affiliated Hospital of Nanchang University received 20 patients with H7N9 avian influenza, with an average age of 60.1 卤11.7 years. Among them, 60% of the patients had a clear history of contact, 50% of the patients had chronic underlying diseases, and 10 cases died. By analyzing the results of 20 patients with H7N9, we found that the average platelet count was low, the levels of C-reactive protein (CRP) and procalcitonin (PCT) were high, the incidence of multidrug resistant bacteria infection was very high in the death group, and the leukocytes were found in the survival group. The average counts of platelets and lymphocytes were all high. Statistical analysis showed that the levels of platelet (PLT), CRP and PCT were closely related to the mortality of patients. Conclusion: the high pathogenicity of H7N9 avian influenza virus can lead to the occurrence of acute respiratory distress syndrome (ARDS) and even the high death rate of (MODS), in multiple organ dysfunction syndrome. The PLT,CRP,PCT level can be used to predict the clinical outcome of the patients.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R511.7

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