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-  2018 

湖南省 2013 至 2017 年人感染 H7N9 禽流感成人住院患者临床特征分析

DOI: doi:10.7507/1671-6205.201801025

Keywords: 人感染 H7N9 禽流感, H7N9, 禽流感, 临床特征, 抗病毒

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Abstract:

目的总结和分析湖南省人感染 H7N9 禽流感确诊病例的流行病学资料和临床特征,为该病的防控、诊治提供科学依据。方法收集湖南省 2013 年 3 月 1 日至 2017 年 4 月 20 日期间报告的人感染 H7N9 禽流感实验室确诊病例 91 例,除外年龄<18 岁(n=2)及重要数据缺失(n=10)的患者,共 79 例 H7N9 患者纳入分析。总结该病的人口统计学资料、临床特点及抗病毒药物使用情况。结果湖南省内人感染 H7N9 禽流感发病集中在第二波和第五波,第五波中患病人数超过前 4 波总和,但流行病学特征、临床症状及病死率并无明显变化。第五波中抗病毒药物应用更积极,从发病到抗病毒药物使用时间比第二波短[(6.3±2.4)d 比(7.6±2.4)d,P=0.047]。多因素 Logistic 回归分析显示休克是 H7N9 患者死亡的独立危险因素(OR=4.683,95%CI 1.136~19.301,P=0.033)。奥司他韦组、奥司他韦+帕拉米韦组、帕拉米韦组患者的病死率无显著差异。结论湖南省第五波人感染 H7N9 禽流感疫情较前扩散,但临床特征变化不大,抗病毒治疗应更加积极。休克是 H7N9 患者死亡的独立危险因素。奥司他韦和帕拉米韦联合抗病毒并不显著改善病死率

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