Prognosis and efficacy of integrative treatment for novel H7N9 avian influenza virus infection in human / 中华传染病杂志

ABSTRACT

Objective This study aimed to analyze the clinical features of novel H7N9 avian influenza virus infection in human and its prognosis after integrative treatment.Methods Eighteen H7N9 infected patients were admitted to Shanghai Public Health Clinical Center from 5 April 2013 to 19 April 2013,and were divided into mild group (8 cases) and severe group (10 cases) based on their baseline disease conditions.Patients in mild group were administered modified Yinqiao powder and Shengjiang powder,while patients in severe group were administered modified Qinwen Baidu Decoction or Xuanbai Chengqi Decoction,in addition to antiviral,anti infection,glucocorticoids and human immunoglobulin treatment in both groups.Baseline characteristics and outcomes of these patients were analyzed,and factors associated with prognosis were also evaluated.Measurement data were compared by t test or rank sum test,categorical variables were compared by chi square test or Fisher exact test.Factors associated with prognosis were evaluated by Logistic regression analysis.Results Compared to mild group,patients in severe group suffered from a significantly elevated C reactive protein [(102.61± 30.80) mg/L vs (38.44± 22.31) mg/L; t=4.717,P＜0.01],and significantly lowered CD3+,CD4+,CD8+ and CD45+T cell levels (all P＜0.05).Compared to regimens with glucocorticoids and human immunoglobulin,traditional Chinese medicine (TCM) contained therapy achieved a higher recovery rate in H7N9 infected patients,but with no statistical significance (P＞0.05).Univariate Logistic regression analysis showed that myoglobin might be a risk factor associated with prognosis of H7N9 infection (P =0.029),and rnultivariable analysis showed that high levels of myoglobin might be negatively related to the prognosis of H7N9-infected patients,But with no statistical significance (P＝0.053).Conclusions Severe H7N9-infected patients suffer from active inflammation and lowered T cell mediated immune response.Integrative therapy is effective for novel H7N9 avian influenza virus infection,and helps to improve the outcomes of infected patients.