目的 总结甲型H_1N_1流感的流行特征和临床表现,探索早期筛查的有效方法.方法 对2009年5月2日-10月31日在广州市第八人民医院发热门诊就诊的患者进行甲型H_1N_1流感筛查,并对其流行病学资料、临床症状和实验室检测结果进行分析.结果 在3063例接受筛查的病例中,共有272例(8.88%)被确诊为甲型H_1N_1流感,其中重症病例23例(8.46%).190例患者以发热为首发症状,其他常见的症状有咳嗽、咽痛和头痛等.重症病例可出现肌酸激酶同工酶(CK-MB)升高、心电图改变及影像学检查显示肺炎.结论 甲型H_1N_1流感的临床表现与一般季节性流感相似,但传染性较强.随着重症病例的增多,筛查时应加强心肌酶谱检测以及心电图和胸部X线检查,以便尽早发现甲型H_1N_1流感重症病例,降低病死率.%Objective To screen influenza A(H_1N_1)from patients in fever clinic.Methods Influenza A(H_1N_1)screening was performed from patients in fever clinic of Guangzhou No.8 People's Hospital during May 2 to October 31,2009.Epidemiological data,clinical symptoms and the laboratory findings were analyzed.Results In 3 063 patients who received screening,272(8.88%)were diagnosed as influenza A(H_1N_1),23(8.46%)of whom were severe cases.Fever as the initial symptom was observed in 190 patients,and other frequent symptoms included cough,angina and headache,etc.Increased creatine kinase isoenzyme(CK-MB),electrocardiogram change or pneumonia images appeared in severe cases.Conclusions Clinical symptoms of influenza A(H_1N_1)are similar to those of seasonal influenza but with higher infectivity.Myocardial enzyme tests,electrocardiogram and chest X ray examination should be taken for early diagnosis of severe cases.
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