资源描述：
《重症甲型h1n1流感病毒肺炎的临床和病理0(1)》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、32栽蚤葬灶躁蚤灶酝藻凿允熏Jan圆园10熏灾燥造38晕燥1甲型H1N1流感专题重症甲型H1N1流感病毒肺炎的临床和病理特征*吟李冠华张力李月川贾玮张冬睿高淑连赵勇摘要目的：探讨危重症甲型H1N1流感病毒（甲流）肺炎患者的主要临床特点，分析其气道内分泌物及肺、心脏病理学改变与持续性低氧血症的关系。方法：回顾性分析入住呼吸重症监护病房（RICU）的24例危、重症甲流肺炎患者的临床资料。24例均用抗病毒治疗（达菲剂量75或150mg）每日2次，24例中20例用激素治疗，6例行气管插管机械通气治疗。结果：24例患者平均年龄（48.25依19.73）岁，孕产妇
2、、肥胖及有慢性基础病者15例。进行性气短、咳嗽、肌肉酸痛是主要症状。双肺多发实变影22例（91.67%）。入院后5例气道内分泌物中蛋白质为34.1~37.7g/L，乳酸脱氢酶（蕴DH）为792~1890U/L。白细胞计数为（0.722~1.470）伊109/L，中性粒细胞0.21~0援源源，单核细胞为0.111~0.560，嗜酸粒细胞为0.027~0.110，嗜碱粒细胞为0.018~0.054。病理学变化有肺透明膜形成、肺泡腔塌陷、心肌细胞变性和心肌灶性坏死。气管插管机械通气支持治疗6例，死亡5例，病死率20.83%。结论：气道内分泌物LDH、蛋白质升
3、高、炎性细胞增多是危重症甲流肺炎患者肺部病理损害的表现；机械通气支持治疗对于肺内广泛实变者效果不理想，且相关的并发症是部分患者病情加重或死亡的促发因素。关键词流感病毒A型,H1N1亚型流感,人肺炎,病毒性危重病重症监护病房呼吸,人工奥司他韦病理学,临床肺心脏ClinicalandPathologicalFeaturesofSevereInfluenzaAH1N1InfluenzaVirusPneumoniaLIGuanhua,ZHANGLi,LIYuechuan,JIAWei,ZHANGDongrui,GAOShulian,ZHAOYongTianji
4、nMedicalUniversity,Tianjin300070,ChinaAbstractObjective：ToinvestigatethemainclinicalfeaturesofcriticallyillpatientswithinfluenzaA(H1N1)influenzaviruspneumonia,andtherelationshipbetweenairwaysecretionsandcardiopulmonarypathologychangewithcontinuoushy鄄poxemia.Methods:Theretrospect
5、iveanalysiswasmadeincriticallyillpatientswithH1N1influenzaviruspneumoniaadmit鄄tedtoarespiratoryintensivecareunit(RICU).Twenty-fourpatientswerealladministratedantiviraldrugs(oseltamivir75/150mgBid).Twentyofthemweresubjectedtoapplicationofhormonaltherapy,and6ofthemwithmechanicalve
6、ntilation.Results:Theaverageageof24patientswas(48.25依19.73)yearsold.Fifteenofthemwerepregnantwomen,obesityandwhosufferedfromchronicunderlyingdiseases.Themainsymptomsofthemwereprogressiveshortnessofbreath,coughandmyal鄄gia.ItwasfoundbyX-raythat22patients(91.67%)hadmultiplelungcons
7、olidationshadow.Afteradmission,airwaysecre鄄tionswerecollected,andtheproteinconcentrationofwhichwas34.1-37.7g/Lin5cases.Theconcentrationofl-lactatedehy鄄drogenase(LDH)was792-1890U/L.Whitebloodcellcountwas(0.722-1.470)伊109/L袁included0.21-0.44neutrophils,0.111-0.560mononuclearcells,
8、0.027-0.110eosinophils,0.018-0.054basophils.Pat
