论文部分内容阅读
目的分析我院收治的46例甲型H1N1流感病毒性肺炎(甲流肺炎)患者的临床特点,探讨其发展为呼吸衰竭的危险因素。方法收集我院2009年10月至2010年1月收治的46例甲型H1N1流感病毒性肺炎患者的一般情况、症状、体征、实验室结果,治疗方案等资料,并分为呼吸衰竭组和非呼吸衰竭组。结果 14例甲流肺炎患者发生呼吸衰竭,其中1例自动出院。所有非呼吸衰竭患者痊愈。呼吸衰竭组与非呼吸衰竭组患者在呼吸困难(10例vs6例)、咯血(10例vs5例)、淋巴细胞减少(158±18)/μlvs(192±26)/μl、氧合指数(182±23)mmHgvs(426±45)mmHg、器官功能不全评分中位数(4vs1)、入院时胸片浸润影(2.3±1.3)vs(1.2±0.8)存在显著差异(P<0.01)。与非呼衰竭组相比,呼吸衰竭组患者住院中位时间长(26 dvs5 d,P=0.000 1)。多因素Logistic回归分析显示甲流肺炎患者发生呼吸衰竭与发病至首剂奥司他韦超过48 h,淋巴细胞计数≤600/μl,入院时SOFA评分≥4分,X线检查肺部浸润影≥75%相关。结论发病至首剂使用奥司他韦超过48 h,淋巴细胞计数≤600/μl,入院时SOFA评分≥4分,X线检查肺部浸润影≥75%是甲流肺炎发生呼吸衰竭的危险因素。
Objective To analyze the clinical features of 46 patients with influenza A (H1N1) pneumonia treated in our hospital and explore the possible risk factors for the development of respiratory failure. Methods The data of 46 cases of influenza A (H1N1) virus pneumonia admitted to our hospital from October 2009 to January 2010 were collected and analyzed. The data were divided into respiratory failure group and non-respiratory failure group Respiratory failure group. Results Respiratory failure occurred in 14 cases of A pneumonia, of which 1 case was discharged automatically. All patients with non-respiratory failure recovered. Patients with respiratory failure and non-respiratory failure had respiratory failure (10 vs 6), hemoptysis (10 vs 5), lymphopenia (158 ± 18) / μlvs (192 ± 26) / μl, and oxygenation index There was a significant difference (P <0.01) in the infiltration of chest radiograph (2.3 ± 1.3) vs (1.2 ± 0.8) on admission. The median organ dysfunction score was (4 ± 1) ± 23 mmHg vs 426 ± 45 mmHg. Patients in the respiratory failure group had longer median hospital stays (26 d vs 5 days, P = 0.000 1) than non-exhaled patients. Multivariate logistic regression analysis showed respiratory failure and onset of the first dose of oseltamivir in patients with A-flow pneumonia over 48 h, lymphocyte count ≤600 / μl, SOFA score ≥4 on admission, pulmonary infiltrates on X-ray ≥ 75% related. Conclusions The incidence of respiratory failure due to metofloxacin is more than 48 h after onset of the first dose of oseltamivir, more than 48 h of oseltamivir, with a lymphocyte count of ≤600 / μl, SOFA score of ≥4 at admission, and ≥75% of pulmonary infiltrates on X-ray .