重症甲型H1N1流感肺炎胸部X线表现1例报告及文献复习

Chest radiographic findings of swine-origin influenza A(H1N1): a case report and review of the literature

目的讨论甲型H1N1流感病毒感染的胸部X线表现与临床治疗经过。方法结合文献复习前瞻性地分析1例经实验室检验确诊的甲型H1N1流感患者X线胸片表现及临床结局。结果起初X线胸片显示双肺透亮度减低,双肺野内可见斑片状或磨玻璃样阴影,两肺门、心影、两膈面以及两肋膈角均模糊,经过针对性抗病毒治疗及支持治疗,肺内病灶迅速吸收,临床症状与体征均得到有效控制和明显改善,住院86 d后痊愈出院。结论甲型H1N1流感病毒感染其胸部X线表现缺乏特征性,临床确诊有赖于流行病学资料和实验室检验,而患者的良好预后取决于抗病毒为主的综合治疗与精心监护。

Objective To discuss the chest radiographic findings of swine-origin influenza A（H1N1） and its therapeutic process.Methods Chest radiographic findings of a case 21 year-old female patient with H1N1 infection confirmed by laboratory test were prospectively analyzed together with review of the literature.Results Initial chest radiograph showed that the transparency of both lung fields was decreased;the patchy or ground-glass shadows were found in both lungs;the margin of both hilus pulmonis,heart,both diaphragmatic surface,and both costofronic angle were ill-defined.Following the comprehensive therapy which was predominated by antivirus drugs,the intrapulmonary lesions were quickly absorbed,while the clinical symptoms and signs were controlled effectively or improved markedly and the patient made a remarkable recovery from the illness and was discharged from the hospital after hospitalized for 86 days.Conclusion Because the chest radiography of H1N1 lacks specific signs,the clinically definite diagnosis needs epidemiologic data and laboratory test,while the good prognosis of the patient depends on the comprehensive therapy predominated by antivirus drugs and careful surveillance and nurse.