上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (1): 120-.doi: 10.3969/j.issn.1674-8115.2012.01.025

• 短篇论著 • 上一篇    下一篇

甲型H1N1流感重症患者的临床及影像学特点

蔡晓婷, 时国朝   

  1. 上海交通大学 医学院附属瑞金医院呼吸科, 上海 200025
  • 出版日期:2012-01-28 发布日期:2012-01-29
  • 通讯作者: 时国朝, 电子信箱: shiguochao@hotmai.com。
  • 作者简介:蔡晓婷（1987—）, 女, 硕士生；电子信箱: xiaotingc@yahoo.cn。

Clinical and imaging features of patients with severe influenza A (H1N1)

CAI Xiao-ting, SHI Guo-chao   

  1. Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2012-01-28 Published:2012-01-29

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摘要：

目的 探讨甲型H1N1流感（甲流）危重症病例的影像学特征及其临床特点。方法 上海交通大学医学院附属瑞金医院2009年12月—2010年2月共收治13例重症甲流确诊患者，其中男性10例，女性3例；年龄24~59岁，中位年龄50岁。回顾性分析患者的临床症状、实验室检查结果、影像学资料、治疗措施及预后。结果 所有患者均以发热、咳嗽为主要症状。实验室表现为白细胞数量下降，尤其是淋巴细胞数量减少，乳酸脱氢酶（LDH）水平升高。胸部X线片及CT检查主要表现为两肺多发散在斑点或团片状模糊影，部分可融合呈大片状实变影。予以抗病毒、糖皮质激素、抗生素等综合支持治疗后，11例好转，1例并发真菌感染，1例死亡。结论 甲流危重病例的影像学表现为肺叶或间质炎症浸润，病情重、进展快，可导致死亡，早期识别并及时给予积极治疗可取得较好的疗效。

关键词: 重症甲型H1N1感染, 临床表现, 影像学

Abstract:

Objective To investigate the imaging and clinical features of patients with severe influenza A (H1N1). Methods Thirteen patients suffering from severe influenza A (H1N1) were admitted to Ruijin Hospital affiliated to Shanghai Jiaotong University School of Medicine from December 2009 to February 2010, among whom 10 were males and the other 3 were females, with the median age of 50 years (24 to 59 years). The clinical features, laboratory findings, imaging features, treatment and outcomes of these patients were retrospectively analysed. Results The most common symptoms were fever and cough. The laboratory findings were decrease of the numbers of white blood cells, especially lymphocytes, and increase of lactate dehydrogenase (LDH) level. The major findings of chest radiograph and CT were bilateral ground-glass opacities and areas of consolidation. After anti-virus, corticosteroids, antibiotics and supporting therapy, the symptoms of 11 patients relieved, 1 patient had fungal infection and 1 patient died. Conclusion The major imaging findings of patients with severe influenza A are bilateral mixed interstitial or alveolar infiltrating shadows. The disease progresses quickly and may lead to death, while early diagnosis and early treatment may achieve better therapeutic effects.

Key words: severe influenza A (H1N1), clinical feature, imaging feature