Abstract:

Objective　To investigate the clinical features and treatment of influenza A （H1N1） in children. Methods　Clinical data of 12 children with severe influenza A （H1N1） were analyzed retrospectively. Results　12 patients were all fever onset， of whom， 9 were respiratory symtom onset and with sore throat， cough， expectoration and other flu-like symptoms； 1 case was with diarrhea of digestive symptom onset and 1 case was neurological symptom onset； 2 patients were with obvious asthmatic suffocation and dyspnea； 3 children were heard with coarse rales and wet rales in both lungs， and 2 cases were heard with wheezing sound. Besides， the white blood cells（WBC）count in 12 patients showed that 4 cases were with high WBC count， while 3 low； neutral category of WBC： 4 cases increased， 4 reduced；lymphocyte ratio： 4 cases were high， 2 cases low； platelet count： 1 case reduced， and 1 increased. ALT of 6 cases increased， AST of 7 cases increased， LDH of 7 cases increased， CK of 7 cases increased and CK-MB in 3 cases increased. With the patients’ condition improved，WBC， liver function and myocardial enzymes returned to the normal level. Conclusion　The symptoms of patients with severe influenza A （H1N1） are all respiratory tract onset and the main target organs are the lungs， often  associated with bacterial and mycoplasmal infection，and with the emergence of various complications involving multiple-organ dysfunction. The conditions of children with neurological symptom onset in particular progress rapidly and they are in greater danger.

Key words: severe illness； , influenza A （H1N1）； pneumonia； respiratory failure； cerebral edema

摘要：

目的　探讨甲型H1N1 流感患儿的临床特点及治疗。方法　对2009 - 11 - 04 — 2009 - 12 - 24桂林市人民医院收治的12例甲型H1N1流感重症患儿的临床资料进行回顾性分析。结果　12例患儿均有发热，其中10例以呼吸道症状起病，如咽痛、咳嗽、咳痰等流感样症状；1例以消化系统症状（腹泻）起病；1例以神经系统症状起病；2例伴明显喘憋、呼吸困难；3例双肺闻及痰鸣音、湿啰音，2例闻及喘鸣音。12例患儿白细胞计数增高4例，降低3例；中性粒细胞比例增高4例，降低4例；淋巴细胞比例增高4例，降低2例；血小板计数降低1例，增高1例。6例丙氨酸转移酶（ALT）增高，7例天冬氨酸转移酶（AST）增高，7例乳酸脱氢酶（LDH）增高，7例肌酸激酶（CK）增高，3例肌酸激酶同工酶（CK-MB）增高。随着患儿病情好转，白细胞、肝功、心肌酶恢复正常。结论　甲型H1N1流感重症患儿多以呼吸道症状发病，主要靶器官是肺，常合并细菌、支原体感染，出现各种并发症累及多脏器功能。以神经系统症状起病患儿进展迅速、病情凶险。

关键词: 重症；甲型H1N1 流感；肺炎；呼吸衰竭；脑水肿