Clinical and Pathological Features of Severe Influenza A H1N1 Influenza Virus Pneumonia
10.3969/j.issn.0253-9896.2010.01.011
- VernacularTitle:重症甲型H1N1流感病毒肺炎的临床和病理特征
- Author:
Guanhua LI
;
Li ZHANG
;
Yuechuan LI
;
Wei JIA
;
Dongrui ZHANG
;
Shulian GAO
;
Yong ZHAO
- Publication Type:Journal Article
- Keywords:
influenza A virus;
H1N1 subtype;
influenza;
human;
pneumonia;
viral;
critical illness;
intensive care units;
respiration;
artificial;
oseltamivir;
pathology;
clinical;
lung;
heart
- From:
Tianjin Medical Journal
2010;38(1):32-35,后插2
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the main clinical features of critically ill patients with influenza A (H1N1) influenza virus pneumonia, and the relationship between airway secretions and cardiopulmonary pathology change with continuous hypoxemia. Methods: The retrospective analysis was made in critically ill patients with H1N1 influenza virus pneumonia admitted to a respiratory intensive care unit(RICU). Twenty-four patients were all administrated antiviral drugs (oseltamivir 75/150 mg Bid). Twenty of them were subjected to application of hormonal therapy, and 6 of them with mechanical ventilation. Results: The average age of 24 patients was (48.25±19.73) years old. Fifteen of them were pregnant women, obesity and who suffered from chronic underlying diseases. The main symptoms of them were progressive shortness of breath, cough and myalgia. It was found by X-ray that 22 patients(91.67%) had multiple lung consolidation shadow. After admission, airway secretions were collected, and the protein concentration of which was 34.1-37.7 g/L in 5 cases. The concentration of l-lactate dehydrogenase(LDH) was 792-1 890 U/L. White blood cell count was (0.722-1.470)×10~9/L, included 0.21-0.44 neutrophils, 0.111-0.560 mononuclear cells, 0.027-0.110 eosinophils, 0.018-0.054 basophils. Pathological changes of these patients were hyaline membrane formation, alveolar cavity collapse, myocardial cell degeneration and focal myocardial necrosis. Intubation and mechanical ventilation were performed in 6 cases, 5 of them dead and the mortality rate was 20.83%. Conclusion: The lung pathological damages were increased LDH and protein in airway secretions, and increased count of inflammatory cells. Effect of mechanical ventilation was not satisfied in part of patients who had diffuse lung consolidation in X-ray, and the related complications leaded to exacerbation or death in part of them.
