危重型甲型HIN1流感病例的临床特点及预后分析

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H1N1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H1N1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H1N1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。

Clinical features and prognosis of critical influenza A (H1N1)

Objective： To raise the awareness and Methods ：Two patients with critical influenza A （H1N1） to explore treatments of critical influenza A （H1N1）. successfully rescued in our department were reviewed on their clinical features, treatments and prognosis. Treatments and outcomes of complicating acute promyelocytic leukemia or acute respiratory failure in influenza A/H1 N1 were also investigated. Results：Both patients were febrile with body temperature above 38.0 degrees Celsius, and were diagnosed with influenza A/H1N1 based on positive RT-PCR detection of H1 N1 virus from throat swabs. After hospitalization, complications were noted in both cases, including acute promyelocytic leukemia in one and acute respiratory failure in another. Antiviral therapy with Oseltamivir was started in the patients as soon as possible, added with other symptomatic or supportive treatments. After a 5-day course of antiviral therapy, the both patients resumed normal temperature, tested negative in a follow- up detection of H1N1 virus, and experienced significant relief of complications. Conclusion： Critical Influenza A （H1N1） may progress rapidly and become life-threatening. Favorable therapeutic efficacy may be achieved by proper reasonable clinical diagnosis, timely antiviral therapy and symptomatic supportive care during the early stage.