Clinical Characteristics Of Seasonal Influenza A Viral Pneumonia And Human Infection With Highly Pathogenic Avian Influenza A Viral (H7N9) Pneumonia

Objective: To understand the epidemiology,clinical characteristics and treatment methods of patients with seasonal influenzaviral pneumonia(H1N1 and H3N2)andhuman infection with highly pathogenic avian influenza A viral(H7N9)pneumonia,we can promptly detect and distinguish the different subtypes of the virus infection.Than we can give early,active and reasonable treatment for thosehighly suspected and confirmed patients to avoid the spread of flu and the incidence range of exacerbations.Methods: We conducted a retrospective study on the clinicalcharacteristics,therapy experience andefficacy of the hospitalizedpatients with seasonal influenza a viral pneumonia(H1N1 18 and H3N2 13)and H7N9(27)avian influenza a viral pneumonia by investgating the complete clinical data.Results:1.The proportion of male and female in group H1N1 and group H3N2 was more consistent,but in group H7N9,the majority of men were male,but there was no significant difference in sex comparison between the three groups.The average age of patients in H1N1,H3N2,and group H7N9 was 51.72,62.46 and 58.00 years,respectively.No confirmed poultry contact history was found in the H1N1 group,with 15.4 percent in the H3N2 group and 64.3 percent in the H7N9 group.2.Three groups of influenza virus pneumonia patients had fever,cough,sputum,dyspnea,moist rales and other similar flu like symptoms and signs,but the H7N9 group of viral pneumonia in patients with fatigue and muscle pain symptoms were significantly higher than H1N1 group and H3N2 group(P<0.05).3.The level of WBC and LY in H7N9 group was significantly lower than that of group H1N1 and H3N2 group,there were statistically significant differences(P<0.05);The level of CRP,PCT,ALT,AST,LDH and CK in H7N9 group was significantly higher than that of group H1N1 and H3N2 group,there were statistically significant differences(P<0.05);The level of Pa O2 in patients with H7N9 influenza virus pneumonia was significantly lower than that of group H1N1 and H3N2 group,and the difference was statistically significant(P<0.05).4.H1N1 group of bacterial culture of sputum was positive in 8 cases,the positive rate was 44.4%;H3N2 group of bacterial culture of sputum was positive in 6 cases,the positive rate was 46.2%;H7N9 of bacterial culture of sputum was positive in 13 cases,the positive rate was 46.4%.three groups of sputum smear test results had no significant difference(P>0.05).5.Comparison between H1N1 group and H3N2 group,GGO,and GGO with real real positive rate showed no significant difference(P>0.05);group H1N1 and 22 in group H7N9,pure GGO,GGO with real positive rate differences were statistically significant(P<0.05);H3N2 group and H7N9 group compared with those of pure GGO,simple consolidation and GGO with real positive rate differences were statistically significant(P<0.05).6.The improvement rate of H1N1 group and H3N2 group were more than 80%,while the H7N9 group after receiving medical treatment,the improvement rate is only about 35%.The improvement rate of H7N9 group was lower than that of H1N1 group and H3N2 group There was a significant difference in the improvement rate between the three groups(P<0.05).The rate of invasive mechanical ventilation and mortality in patients with seasonal influenza virus(H1N1 and H3N2 influenza)were significantly lower than those in patients infected with H7N9 influenza virus pneumonia.Conclusions:1.The proportion of poultry infected with human H7N9 avian influenza virus infection patients with a history of poultry exposure and the prevalence of fatigue and muscle soreness were significantly higher than those of patients with influenza A(H1N1 and H3N2 influenza).2.Compared with seasonal influenza A virus(H1N1 and H3N2 influenza)pneumonia patients,LY level of H7N9 avian influenza virus pneumonia decreased significantly,while ALT,AST,LDH,CK,CRP,PCT and other indicators levels increased significantly.3.All patients with pneumonia infected with H7N9 avian influenza virus showed GGO imaging combined with consolidation.The proportion of GGO combined with consolidation was significantly higher than that of patients with influenza A(H1N1 and H3N2 influenza)4.Three groups of patients with pulmonary images appear exudative high density shadow,with patchy or patchy shadow mostly,bilateral lesions are more common.H7N9 group of lung CT all showed more obvious ground glass opacity(GGO),and the majority of patients had lung consolidation,while H1N1 group and H3N2 group were observed in GGO and lung consolidation patients with very few.4.The rate of invasive mechanical ventilation and mortality in patients with seasonal influenza A(H1N1 and H3N2 influenza)pneumonia is significantly lower than those infected with H7N9 avian influenza virus pneumonia.