【摘要】 目的 了解北京地區(qū)400例新型甲型H1N1流感患者的流行病學和臨床特征，總結規(guī)律，進一步指導臨床診治?！》椒ā?009年5-12月期間，收治400例甲型H1N1流感確診病例，主要采用描述性流行病學方法對患者資料進行回顧性分析，并運用單因素方差分析的方法對結果進行檢驗?！〗Y果 患者以青年和兒童人群為主，47.0%的患者有明確甲型H1N1流感接觸史，主要癥狀包括發(fā)熱（98.8%）、咳嗽（85.8%）、咽痛（58.5%）。咽部充血（94.0%）和扁桃體腫大（49.5%）為主要體征。外周血白細胞正?；蚱?，349例（82.3%）患者血清鐵降低，268例（72.6%）患者C反應蛋白升高。在發(fā)病后不同時間內給予奧司他韋治療的患者發(fā)熱持續(xù)時間和咽拭子的陰轉時間有顯著差異（Plt;0.001）?！〗Y論 新型甲型H1N1流感發(fā)病多以青年和兒童人群為主，以流感樣癥狀為主，多數(shù)癥狀輕微，預后良好，C反應蛋白和血清鐵的變化可能對于早期診斷有指導價值，奧司他韋早期抗病毒治療可以縮短病程。【Abstract】 Objective To investigate the clinical and epidemiologic characteristics of pandemic influenza A (H1N1) virus infection in Beijing. Methods The epidemiological information and clinical characteristics of 400 patients with pandemic influenza A (H1N1) virus infection hospitalized in Beijing 302 Hospital from May to December, 2009 were analyzed retrospectively by descriptive epidemiology. One-way ANOVA was used to assess the results. Results H1N1 virus infection preferentially affected adolescents and young adults. The mean age of the patients was 23 years. A total of 189 (47.0%) of the patients had an identifiable epidemiologic link to another confirmed patient. The most common symptoms were fever (98.8%), cough (85.8%) and sore throat (58.5%). The main physical signs were pharyngeal portion congestion (94.0%) and antiadoncus (49.5%). The number of leukocytes in the peripheral blood was normal or low. The decreased serum iron and elevated C-reaction protein were found in 82.3% and 72.6% of the patients. There was significant difference in the duration of fever and viral shedding from throat swabs among the patients who accept the antiviral medication within the different time. Conclusion H1N1 virus infection preferentially affects adolescents and young adults, and presents with influenza-like illness. The clinical course of H1N1 virus infection is generally mild. The change of C-reaction protein and serum iron may be favorable for the diagnosis of H1N1. Early antiviral treatment may shorten the duration of fever and viral shedding.
根據(jù)甲型H1N1流感病毒美國加利福尼亞毒株基因序列(A/California/07/2009(H1N1)),全基因合成甲型流感病毒血凝素(HA)編碼基因,利用輔助病毒依賴型腺病毒載體(HDAd)骨架質粒pSC15B,構建可表達HA基因的HDAd/HA DNA分子載體,以磷酸鈣法轉染293Cre4細胞,與輔助病毒H14連續(xù)共感染,獲得HDAd/HA載體,并大量制備和純化,進行形態(tài)觀察和體外感染的初步鑒定。透射電鏡下觀察HDAd/HA載體具有典型腺病毒形態(tài);與輔助病毒H14共感染293細胞,RT-PCR檢測HA基因有轉錄,顯示成功構建HDAd/HA重組腺病毒載體,為甲型流感病毒體內免疫效果和免疫保護作用的研究奠定實驗基礎。