2020 年第 9 期 第 15 卷

轻症甲型流感患者不同中性粒细胞百分比与单独应用抗病毒药物疗效的关系

Relationship between different neutrophil percentages and the efficacy of antiviral drugs in patients with mild influenza A

作者：李佳佳齐文杰王超李世荣

英文作者：Li Jiajia Qi Wenjie Wang Chao Li Shirong

单位：首都医科大学附属北京友谊医院感染内科100050

英文单位：Department of Infectious Diseases Beijing Friendship Hospital Capital Medical University Beijing 100050 China 

关键词：甲型流感；中性粒细胞；抗病毒药物

英文关键词：InfluenzaA;Neutrophils;Antiviraldrug

• 摘要：

• 目的 分析临床诊断轻症甲型流感患者不同中性粒细胞百分比与单独应用抗病毒药物治疗效果之间的关系。方法收集2019年1月1—31日首都医科大学附属北京友谊医院发热门诊就诊的轻症甲型流感病毒感染201例患者资料，均为白细胞水平正常患者，根据中性粒细胞百分比将其分为中性粒细胞正常/降低组（中性粒细胞百分比≤75%，71例）和中性粒细胞升高组（中性粒细胞百分比＞75%，130例）。所有患者均予抗病毒药物（奥司他韦）口服治疗5 d，通过电话随访，了解2组患者的体温恢复时间并进行比较。结果 中性粒细胞升高组患者体温高于、发热天数少于正常/降低组［（38.4±0.6）℃比（38.1±0.7）℃、1（1，2）d比2（1，3）d］，差异均有统计学意义（P＝0.005，P＜0.001）。中性粒细胞正常/降低组体温恢复时间为1（1，2）d，中性粒细胞升高组体温恢复时间为2（1，2）d，组间比较差异无统计学意义（P＝0.467）。结论 在轻症甲型流感患者中，无论中性粒细胞是否升高，单独应用抗病毒药物均可较快治愈，因此中性粒细胞升高并不能作为临床应用抗菌药物的指征。

• Objective To analyze the effect of antiviral drugs on level of neutrophils in clinical diagnosis of mild influenza A. Methods Clinical data of 201 patients diagnosed of mild influenza A virus infection admitted to  Beijing Friendship Hospital, Capital Medical University in January 2019 were selected. All patients had normal white blood cell levels. According to the percentage of neutrophils, they were divided into neutrophil increase group (increase group， 130 cases， ＞75%) and neutrophil normal or decrease group (normal group, 71 cases, ≤75%). The patients were given antiviral drug (oseltamivir) for 5 days. The temperature recovery time was compared. Results The body temperature of increase group was higher and duration of fever was shorter than that of normal group ［(38.4±0.6)℃ vs (38.1±0.7)℃, 1（1，2）d vs 2（1，3）d］; the difference was statistically significant(P=0.005, P<0.001). The recovery time of body temperature was 1（1，2）d in normal group and 2（1，2）d in increase group, there was no significant difference between the two groups(P=0.467). Conclusions Antiviral drugs alone can treat patients with mild influenza A. Increase neutrophils may not be an indication for the use of the antibiotics.