Comparative Analysis Of The Clinical Characteristics Of Influenza B Pneumonia And Influenza A Pneumonia

Background Influenza is an acute respiratory infection caused by the influenza virus,one of the main public health problems that mankind faces.Most of the current studies focused on the epidemiology and clinical manifestations of the influenza A virus.The researches of patients with influenza pneumonia were relatively rare.For the case of influenza A virus also includes the avian-origin influenza A(H7N9),Their critical diseases were often seen and the prognosis was poor.Therefore,it is necessary to make differential diagnosis of influenza B virus pneumonia,influenza A virus pneumonia,and the different subtypes of influenza A virus pneumonia,to achieve the purpose of early diagnosis,early treatment,prognostic prognosis and improve prognosis.Methods We collected 82 patients with the positive results of the influenza virus nucleic acid test and the initial chest imaging confirmed with pneumonia in the first affiliated hospital of Soochow university from May 2015 to June 2017.Among them,23 cases were influenza B virus pneumonia,and 59 cases were influenza A virus pneumonia.Among the 59 cases of influenza A virus pneumonia,28 cases were avian-origin influenza A(H7N9)pneumonia and 31 cases were seasonal influenza A(H1N1,H3N2)pneumonia.We analyzed and compared their clinical characteristics.Results Compared with influenza B virus pneumonia,patients with influenza A virus pneumonia had more cases of live poultry exposure(P<0.05),more proportion of muscle soreness(P<0.05).And the latter group had less white blood cell count,lymphocyte count and platelet count(all P<0.05),significantly increased aspartic acid transferase,lactate dehydrogenase and creatine kinase(P<0.05),and the incidence of GGO combined consolidation was higher(P<0.05).The platelet count of patients with seasonal influenza A(H1N1,H3N2)pneumonia was significantly less than that of influenza B virus pneumonia(P<0.05).Compared with influenza B virus pneumonia,patients with the avian-origin influenza A(H7N9)pneumonia were prone to shortness of breath(P<0.05),and muscle pain symptoms(P<0.001).And the latter group had less white blood cell count and lymphocyte count,and AST,LDH and CK were significantly increased(all P values<0.001),the incidence of GGO combined consolidation was higher(P<0.001).While the former group were more likely to be merger pleural effusion(P=0.001).We defined ALC value as the weighted value of the increase ratio of AST,LDH and CK.ALC/LY was the ratio of ALC value to LY.The sensitivity of the ALC positive diagnosis of the avian-origin influenza A(H7N9)pneumonia was 96.4%,the specificity was 66.7%,the area under the receiver operator characteristic curve was 0.903.The sensitivity of the ALC/LY positive diagnosis of the avian-origin influenza A(H7N9)pneumonia was 64.3%,the specificity was 96.3%,the area under the receiver operator characteristic curve was 0.926.Conclusions There are significant differences in epidemiology,clinical symptoms and radiologic imaging of influenza B virus pneumonia and influenza A virus pneumonia.The blood cells and blood biochemical abnormalities degrees of influenza B viral pneumonia and seasonal influenza A virus(H1N1 and H3N2)pneumonia were milder than avian-origin influenza A(H7N9)pneumonia,and the incidence of pulmonary GGO with consolidation and the mortality rate were lower.ALC and ALC/LY have certain clinical value in the differential diagnosis of avian-origin influenza A(H7N9)pneumonia and other types influenza pneumonia.