【摘要】 目的 探讨甲型流感病毒血凝素（HA）与红细胞的相互作用同机体凝血功能异常之间的关联。方法 选取2024年10月～2025年4月于我院住院、经呼吸道标本核酸检测确诊为甲型流感病毒阳性的患者作为研究对象，收集其临床资料与外周静脉血液样本。采用实时荧光定量逆转录聚合酶链式反应（qRT-PCR）技术，检测患者红细胞、单个核细胞及全血样本中的甲型流感病毒HA基因。根据检测结果，将患者分为病毒血症组与非病毒血症组，并比较两组间炎症、凝血等临床指标的差异。结果 在21例患者中，12例血液中检出病毒HA基因的患者被归入病毒血症组，其余9例未检出HA基因者归入非病毒血症组。病毒血症组HA基因检出情况如下：3例患者的红细胞样本、4例患者的单个核细胞样本以及7例患者的全血样本呈阳性。临床参数比较显示，病毒血症组的凝血酶时间（TT）短于非病毒血症组（P<0.05），降钙素原（PCT）水平则高于非病毒血症组（P<0.05）。病毒血症组中红细胞样本检出HA基因的患者，其中2例红细胞计数与血红蛋白（Hb）浓度均低于病毒血症组的平均水平；同时，其D-二聚体水平、凝血酶原时间（PT）及活化部分凝血活酶时间（APTT）均升高，抗凝血酶Ⅲ（AT）活性降低，炎性指标PCT和C反应蛋白（CRP）水平升高。结论 甲型流感病毒可进入体循环并与红细胞结合，影响患者凝血与炎症因子水平，由病毒HA介导的红细胞凝集可能是流感病毒诱发凝血功能异常的关键机制。更多还原

【Abstract】 Objective To investigate the association between the interaction of influenza A virus hemagglutinin with erythrocytes and the abnormal function in the body. Methods Patients hospitalized at our hospital between Oct 2024 and Apr 2025, who were diagnosed positive for influenza A virus by nucleic acid detection of respiratory specimens, were selected as the study subjects. Their clinical data and peripheral venous blood samples were collected. Quantitative real-time reverse transcription polymerase chain reaction(qRT-PCR) was used to detect the influenza A virus hemagglutinin gene in erythrocytes, peripheral blood mononuclear cells, and whole blood samples. Based on the detection results, patients were divided into a viremia group and a non-viremia group, and the differences in clinical indicators such as inflammation and coagulation were compared between the two groups. Results Among the 21 patients, 12 patients with viral hemagglutinin gene detected in blood were classified into the viremia group, while the remaining 9 patients without detected hemagglutinin gene were assigned to the non-viremia group. In the viremia group, the detection of hemagglutinin gene was as follows: erythrocytes samples from 3 patients, mononuclear cell samples from 4 patients, and whole blood samples from 7 patients tested positive. Comparison of clinical parameters revealed that the thrombin time in the viremia group was shorter than that in the non-viremia group(P<0.05), while the procalcitonin level was higher in the viremia group(P<0.05). Among the patients in the viremia group with hemagglutinin genes detected in erythrocytes samples, two cases exhibited lower red blood cell counts and hemoglobin concentrations compared to the average levels of the viremia group. Meanwhile, their D-dimer levels, prothrombin time and activated partial thromboplastin time were elevated, antithrombin Ⅲ activity was decreased, and the inflammatory markers procalcitonin and C-reactive protein levels were increased. Conclusion Influenza A virus can enter the systemic circulation and bind to erythrocyte, affecting the levels of coagulation and inflammatory factors in patients. The agglutination of erythrocyte mediated by the viral hemagglutinin may be the key mechanism by which influenza virus induces abnormal coagulation function.更多还原