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人感染 H7N9 禽流感

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人感染 H7N9 禽流感. 中南大学湘雅二医院感染科 陈军. 疫情报告. 自 2013 年 2 月以来,中国大陆上海、江苏、浙江、安徽先后发生 H7N9 禽流感病例 20 例, 6 例死亡(截止截止 4 月 7 日 19 : 00 人感染 H7N9 病例数统计). 流行病学特征. 发病年龄: 4-87 岁,平均年龄 54.277 性别:男性 14 例,女性 7 例 地区分布:病例分布于上海 (10 例,死亡 4 例 ) 、江苏 (6 例 ) 、浙江 (3 例,死亡 2 例 ) 、安徽 (2 例 ) ,均为散发病例,目前尚未发现病例间有流行病学关联 - PowerPoint PPT Presentation

Text of 人感染 H7N9 禽流感

  • H7N9

  • 20132H7N9206471900H7N9

  • 4-8754.277147(104)(6)(32)(2)31122111

  • 633.3%27-8754.3351

  • H7N9RNA,(H)(N),16H (H1~H19N(N1~N9) . H7N9, H9N2 21, 41,,pH4.0

  • 6H9N2

  • CDC. Avian Influenza A Virus Infections of Humans. http://www.cdc.gov/flu/avian/gen-info/avian-flu-humans.htm. H4, H5, H6, H7,H9,H10, H11 AIVs.

    //A/H7N71980/3/A/H7N71996/1/A/H5N11997/18/ILIA/H9N21998/5/ ILIA/H9N21999/ 2/ILIA/H7N22002/Virginia1/ILIA/H9N22003/ 1/ILIA/H5N12003/2/ ILIA/H7N72003/89/ILI; 1A/H5N12003, 15602/ ILI, A/H7N2(NY/107)2003/(New York) 1/A/H7N32004/2/ILI; 1LPAI1HPAIA/H5N22005/(Ibaraki)13/A/H7N22007/(Wales)1/ILIA/H9N22007/1/ ILIA/H10N72004/( Ismaillia)2/ ILIA/H10N72010/(New South Wales)7/

  • , H7N9,, ,1

  • 1/100

  • H7N9

  • 87 2013-2-262013-3-41. 2. 3.13

  • 85/

  • D-(2013-03-01)5.73mg/L(2013-03-03) 27.41mg/L(2013-02-27) :501U/L,:27U/L,:480U/L(2013-03-01):311U/L,:28U/L,:1929U/L(2013-03-03) :236U/L,:17U/L,:1751U/L

  • CRP(2013-02-27)114mg/L(2013-03-03) 95mg/L(2013-02-27):6.7mmol/L,:74mol/L,:203mol/L(2013-03-01) :8.1mmol/L,:73mol/L,:206mol/L(2013-03-03) :9.6mmol/L,:95mol/L,:117mol/LC-(2013-02-27):0.81ng/mL

  • 2013-03-04(2013-02-28) (2013-02-27):31U/L,:77U/L,:6.7mol/L,:4.8mol/L,:12.2mol/L,:55.8g/L,:30.7g/L,:25.1g/L,(2013-03-01):50U/L,:17.3mol/L,:109U/L(2013-03-03) :58U/L,:23.6mol/L,:73U/L

  • (2013-02-27):3.7mmol/L,:140mmol/L,:101mmol/L, :1.9mmol/L,:0.96mmol/L,:0.96mmol/L(2013-02-27)8.6mmol/L(2013-03-03):8mm/h

  • -(2013-02-26) PH:7.48,BEb:-0.1mEq/L,PO2:54mmHg,PCO2:29mmHg(2013-02-27) PH:7.42,BEb:4.8mEq/L,PO2:26mmHg,PCO2:45mmHg(2013-02-28) PH:7.52,BEb:6mEq/L,PO2:52mmHg,PCO2:34mmHg

  • (2013-02-27):4.67*10^9/L,:4.11*10^9/L,:88.1%,:11.3%:131g/L,:4.38*10^12/L, :78*10^9/L, (2013-03-03):16.8*10^9/L,:15.52*10^9/L,:92.4%,:4.9%:126g/L,:4.22*10^12/L , :89*10^9/L,

  • I(2013-03-01):0.05ng/mL(2013-03-03) I:0.05ng/mL(2013-03-01) INR:1.17,PT:13.4,TT:23.5,APTT:38.3,FIB:1.85g/L(2013-03-03) INR:1.26,PT:14.4,TT:19.2,APTT:38.7,FIB:1.82g/L(2013-02-27):0.327ng/mLB(2013-03-03):7480pg/mL

  • ++227++34

  • ++IgMOD0.055 H1N1--2009H1N1-- H3N2--H5--IgGOD0.877H7--H9--SARSCoV----

  • --IgMOD0.117 H1N1--2009H1N1-- H3N2--H5--IgGOD2.057H7--H9--SARSCoV----

  • --IgMOD0.01 H1N1--2009H1N1-- H3N2--H5--IgGOD0.934H7--H9--SARSCoV----

  • 272013-03-04 2013-03-10I52

  • T39.40 P100/ R20/Bp120/80mmHg

  • (2013-03-05)HbsAg:> 250.00(+)IU/mL,HBsAb:(-),HbeAg:(-),HBeAb:(+),HBcAb:(+)HIV(2013-03-05) (2013-03-08) C4:0.22g/L,CH50:35U/ml,IgG:11.5g/L,IgA:2.23g/L,IgM:0.59g/L,C3:0.59g/L()(2013-03-05) 6.6mmol/L

  • (2013-03-05) :606U/L,:27U/L,:435 (2013-03-06) :>1600U/L,:37U/L, :1983U/L (2013-03-09) :359U/L,:33U/L, :1377U/LU/L (2013-03-10) :325U/L,:41U/L,:579U/L (2013-03-05) ALT:41U/L, AST:58U/L, TBIL:6.5mol/L, (2013-03-07) ALT:48U/L, AST:106U/L, TBIL:6.7mol/L

  • (2013-03-05) :3.8mmol/L,:72mol/L,:169mol/L, (2013-03-06) :2.9mmol/L, :53mol/L, :117mol/L (2013-03-07) :4.6mmol/L,:51mol/L,:77mol/L D- (2013-03-05) 4.3mg/L (2013-03-06) 5.62mg/LCRP (2013-03-05) 32mg/L (2013-03-10) CRP:22mg/L

  • (2013-03-04) PH:7.44,PHNR:7.423,SB:25.8mEq/L,BEb:2.5mEq/L,PO2:49mmHg,BBp:50.9mEq/L,PCO2:38mmHg,P50:25.7mmHg,:15.8g/dl,AB:25.8mEq/L,TCO2:27mmol/L (2013-03-08) PH:7.55,PHNR:7.473,SB:29mEq/L,BEb:6.8mEq/L,PO2:66mmHg,BBp:53.1mEq/L,PCO2:32mmHg,P50:22.8mmHg,:11g/dl,AB:28mEq/L,TCO2:29mmol/L

  • (2013-03-05):2.1**10^9/L,:1.9**10^9/L,:86.8%,:10.5%, :143g/L,:4.7**10^12/L, :58**10^9/L, (2013-03-10):22.5**10^9/L,:20.02**10^9/L,:89%,:10.2%,:157g/L, :247**10^9/L

  • +3630/SPO262%132/ICU

  • :2932U/L,(:47U/L,:2327U/L:1.41**10^9/L,:0.19**10^9/L,:4.69**10^12/L,:1.64**10^9/L,:86%,:11.6%

  • ++ICU310113037/70/35mmHg42%1210

  • ++IgMOD0.055 H1N1--2009H1N1-- H3N2--H5--IgGOD0.877H7--H9--SARSCoV----

  • (MODS) ,, , , : , /

  • ,,,,,,39,,;

  • 1.,2.,C,

  • (1)() real time PCR(RT-PCR)H7N9(2)H7N9

  • ,,ARDS,

  • (1):,,(2):,H7N9H7N9:

  • H5N1(H1N1(SARS)

  • () () ()1.:,H5N1H1N1,H7N975mg,,5-710mg,2.M2:,

  • (),,(),,

  • SARS 96.2%H7N9

  • H7N92013

  • 1.2.3.H7N94.5.

  • 1.2.3.4.

  • 1.2.3.

  • 1.2.3.

  • 4. 1 2 3 4 5 6 7