38例甲型H1N1流感患者病毒核酸阴转时限的观察

目的观察甲型H1N1流感患者病毒核酸阴转时限。方法选择2009年9月16～27日我院收治的甲型H1N1流感确诊病例38例,经同一名医生进行咽拭子采集,采用RT-PCR方法检测甲型通用、甲1通用、季节性流感、甲型H1N1亚型4个病毒亚型,以甲型通用、甲1通用、甲型H1N1亚型均阴转作为判定病毒核酸阴转的标准。结果 38例甲型H1N1流感患者病毒核酸阴转的时限最短1 d,最长14 d,平均4.5 d;病毒核酸阴转时间主要集中在第3、4、5天,第5天与第4天相比,甲型通用、甲1通用和甲型H1N1的阴转比例均明显增加(P<0.05);发病36 h内接受抗病毒治疗者,病毒核酸阴转平均时间为4.1 d;37～72 h接受抗病毒治疗者,病毒核酸阴转平均时间为5.2 d;有3例甲型通用、甲1通用、甲型H1N1亚型病毒核酸未同时阴转。结论甲型H1N1流感抗病毒治疗1周,大部分患者病毒核酸阴转,不具有传染性;尽早(36 h内)接受抗病毒治疗,可以缩短病毒核酸阴转时间;甲型通用、甲1通用、甲型H1N1亚型具有较好的一致性,对三者未同时阴转的情况,应注意是否同时合并其他甲型流感病毒亚型感染。

Time Limit for Virus Nucleic Acid Negative Conversion in 38 Patients with Influenza A(H1N1)

Objective To observe the time limit for virus nucleic acid negative conversion in patients with influenza A(H1N1).Methods The pharynx swabs of 38 patients with influenza A(H1N1),who were hospitalized in Changchun City Hospital for Infectious Diseases during September 16 to September 27,2009,were collected by the same doctor,and determined for four virus subtypes,i.e.A,A1,seasonal flu and A(H1N1),by RT-PCR,and those negative for subtypes A,A1 and A(H1N1) were judged as virus nucleic acid negative conversion.Results The minimum and the maximum time limits of virus nucleic acid negative conversion of 38 patients were 1 and 14 d respectively,with a mean of 4.5 d.The negative conversion mainly appeared on days 3,4 and 5 after hospitalization,and was significantly higher on day 5 than on day 4(P < 0.05).The mean time for virus nucleic acid negative conversion of patients receiving antiviral therapy within 36 h after onset was 4.1 d,while those within 37 ~ 72 h was 5.2 d.However,the subtypes A,A1 and A(H1N1) of three patients failed to converse simultaneously.Conclusion Most of patients with influenza A(H1N1) were negative for virus nucleic acid and were non-infectious after receiving antiviral therapy for one week.The time for virus nucleic acid negative conversion might be shortened by receiving antiviral therapy as early as possible(within 36 h).The negative conversions of subtypes A,A1 and A(H1N1) were in agreement.When the three indexes were not conversed simultaneously,care shall be taken to determine whether concurrent infection with other subtypes of influenza A virus occurred.