危重型甲型hin1流感病例的临床特点及预后分析

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1、第38卷第5期广州医学院学报V0l_38No．52010年10月ACADEMICJOURNAL0FGUANGZHOUMEDICALCOLLEGE0ct．2010·临床实践·危重型甲型H1N1流感病例的临床特点及预后分析张宿荣叶晓光(广州医学院第二附属医院感染科，广东广州510260)摘要目的：提高对危重型甲型H1N1流感的认识以及探讨危重型病例的临床治疗方法。方法：对本科成功救治的2例甲型H1N1流感危重型患者的临床特点、治疗方法及预后进行分析，并对甲型H1Nl流感并发急性早幼粒细胞白血病、急性呼吸衰竭的治疗及其转归进行分析。结果：2例患者均有发

2、热症状，体温38．0℃以上．咽拭子甲型H1N1流感病毒逆转录一聚合酶链反应(RT-PCR)核酸检测结果均为阳性，诊断为甲型H1N1流感。入院后2例患者均出现不同的并发症，其中1例并发急性早幼粒细胞白血病，1例并发急性呼吸衰竭。治疗上尽早给予奥司他韦抗病毒治疗，以及其他对症支持治疗。完成5d的抗病毒疗程后，体温均恢复正常，复查甲型HlNl流感病毒核酸检测阴性，同时相关并发症也得到明显缓解。结论：危重型甲型HlN1流感，进展快，可危及生命，临床上应早期做出合理诊断以及早期给予抗病毒、对症支持治疗，多可取得良好疗效。关键词甲型H1Nl流感；奥司他韦；临

3、床特点；预后分析中图分类号：R511．7文献标识码：A文章编号：1008—1836(2010)05-0042-03ClinicalfeaturesandprognosisofcriticalinfluenzaA(HIN1)ZHANGSu—rong，YEXiao—guang(DepartmentofInfectiousDiseases，SecondAffiliatedHospital，GuangzhouMedicalCollege，Guangzhou，Guangdong510260，China)AbstractObjective：Toraiseth

4、eawarenessandtoexploretreatmentsofcriticalinfluenzaA(H1N1)．Methods：TwopatientswithcriticalinfluenzaA(H1N1)successfullyrescuedinourdepartmentwerereviewedontheirclinicalfeatures，treatmentsandprognosis．Treatmentsandoutcomesofcomplicatingacutepromyelocyticleukemiaoracuterespirato

5、ryfailureininfluenzaA／H1N1werealSOinvestigated．Results：Bothpatientswerefebrilewithbodytemperatureabove38．0degreesCelsius，andwerediagnosedwithinfluenzaA／H1N1basedonpositiveRT—PCRdetectionofH1N1virusfromthroatswabs．Afterhospitalization，complicationswerenotedinbothcases，includin

6、gacutepromyelocyticleukemiainoneandacuterespiratoryfailureinanother．AntiviraltherapywithOseltamivirwasstartedinthepatientsassoonaspossible，addedwithothersymptomaticorsupportivetreatments．Aftera5-daycourseofantiviraltherapy，thebothpatientsresumednormaltemperature，testednegativ

7、einafollow—updetectionofHIN1virus，andexperiencedsignificantreliefofcomplications．Conclusion：CriticalInfluenzaA(H1N1)mayprogressrapidlyandbecomelife—threatening．Favorabletherapeuticefficacymaybeachievedbyproperreasonableclinicaldiagnosis，timelyantiviraltherapyandsymptomaticsup

8、portivecareduringtheearlystage．KeywordsinfluenzaA／H1N1virus；Osehamiv