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首页> 外文期刊>International journal of infectious diseases : >Retrospective study of risk factors for mortality in human avian influenza A(H7N9) cases in Zhejiang Province, China, March 2013 to June 2014
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Retrospective study of risk factors for mortality in human avian influenza A(H7N9) cases in Zhejiang Province, China, March 2013 to June 2014

机译：2013年3月至2014年6月在中国浙江省的人类甲型H7N9禽流感死亡风险因素回顾性研究

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Background: The influenza A(H7N9) virus causes a serious disease that threatens human health. Fatalities associated with human infections caused by this virus are of great public health concern; however, the possible risk factors are not yet fully known. Methods: A stratified sampling method, incorporating household income levels and a random number table method, was used to select laboratory-confirmed A(H7N9) cases for this study. Eighty-five patients were selected randomly from 139 laboratory-confirmed A(H7N9) cases occurring in Zhejiang Province between March 1, 2013 and June 30, 2014. Data were collected using a standard method. To test the statistical significance among discrete variables, univariate analyses were used to compare two groups. The Kaplan-Meier product-limit method was used to analyze the patient survival fraction. The Cox proportional hazards regression model was used to analyze all variables with p @? 0.05 in the univariate analysis. Lastly, a stepwise procedure was used to construct a final model with a significance level of p > 0.10 for removal and p =60 years (p=0.008), low education level (p=0.030), chronic diseases (p=0.029), poor hand hygiene (p=0.010), time from illness onset to the first medical visit (p=0.029) and to intensive care unit admission (p=0.008), an incubation period of @?5 days (p=0.039), a peak C-reactive protein >=120mg/l (p=0.012), increased initial neutrophil count (p=0.020), decreased initial lymphocyte count (p=0.021), and initial infection of both lungs (p=0.003). Multivariate analysis confirmed that the independent predictors of H7N9 virus infection mortality in Zhejiang, China were hand hygiene (hazard ratio (HR) 5.163, 95% confidence interval (CI) 1.164-22.661), age (HR 1.042, 95% CI 1.007-1.076), and peak CRP (HR 1.009, 95% CI 1.002-1.016). Conclusions: Improvements in immunity, early case identification and treatment, and personal protection measures are key to addressing the high human avian influenza A(H7N9) case fatality rate.
机译：背景：甲型H7N9流感病毒引起严重威胁人类健康的疾病。与这种病毒引起的人类感染有关的致命性引起了公众极大的关注。但是，可能的危险因素尚不完全清楚。方法：采用分层抽样方法，结合家庭收入水平和随机数表方法，选择本实验室确诊的A（H7N9）病例。从2013年3月1日至2014年6月30日在浙江省发生的139例实验室确认的A（H7N9）病例中随机选择了85例患者。采用标准方法收集数据。为了检验离散变量之间的统计显着性，使用单变量分析比较两组。 Kaplan-Meier乘积极限法用于分析患者生存率。使用Cox比例风险回归模型分析所有变量。单因素分析为0.05。最后，采用分步程序构建了最终模型，其去除水平为p> 0.10，p = 60年（p = 0.008），低教育水平（p = 0.030），慢性病（p = 0.029），手部卫生差（p = 0.010），从发病到第一次就诊（p = 0.029）到重症监护室入院（p = 0.008）的时间，潜伏期为5天（？= 0.039）， C反应蛋白峰值> = 120mg / l（p = 0.012），中性粒细胞初始计数增加（p = 0.020），初始淋巴细胞计数减少（p = 0.021）和双肺初始感染（p = 0.003）。多元分析证实，中国浙江省H7N9病毒感染死亡率的独立预测因素是手卫生（危险比（HR）5.163，95％置信区间（CI）1.164-22.661），年龄（HR 1.042，95％CI 1.007-1.076） ）和最高CRP（HR 1.009，95％CI 1.002-1.016）。结论：免疫力的提高，早期病例的识别和治疗以及个人保护措施的提高是解决人类甲型禽流感（H7N9）病死率高的关键。

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