人感染H7N9禽流感重症肺炎患者病情严重程度评价

Evaluation of pneumonia severity to hospitalized patients with H7N9 influenza pneumonia

目的探讨CURB-65评分、肺炎严重度指数(PSI)评分及氧合指数(PO_(2)/FiO_(2))结合外周血淋巴细胞计数在人感染H7N9禽流感重症肺炎患者病情评估中的应用价值。方法收集2016年12月-2017年1月常州地区5例人感染H7N9禽流感确诊死亡病例,分析CURB-65评分、PSI评分及PO_(2)/FiO_(2)结合外周血淋巴细胞计数对H7N9禽流感重症肺炎患者死亡的预测价值。结果5例人感染H7N9禽流感确诊死亡病例中,CURB-65评分1分2例,0分3例,均为低危;PSI评分分别为55分、73分、88分、78分和78分,均为低危;PO_(2)/FiO_(2)分别为143 mmHg、181 mmHg、73 mmHg、185 mmHg和75 mmHg,外周血淋巴细胞计数分别为0.6×10^(9)/L、0.22×10^(9)/L、0.70×10^(9)/L、0.29×10^(9)/L和0.38×10^(9)/L。外周血白细胞总数和血小板计数仅有2例患者低于正常范围。结论CURB-65评分和PSI评分低估H7N9禽流感重症肺炎患者的死亡风险和严重程度,而PO_(2)/FiO_(2)结合外周血淋巴细胞绝对值减低对预测H7N9禽流感重症肺炎患者死亡风险有一定价值。

Objectives To evaluate the role of CURB-65 score,pneumonia severity index(PSI)score and oxygenation index(PO_(2)/FiO_(2))combined lymphocyte count in patients with H7N9 influenza pneumonia.Methods We reviewed 5 patients with H7N9 influenza pneumonia in Changzhou from December 2016 to January 2017.The role of CURB-65 score,pneumonia severity index(PSI)score and oxygenation index(PO_(2)/FiO_(2))combined lymphocyte count in patients with H7N9 influenza pneumonia was evaluated.Results The CURB-65 score and PSI score of patients with H7N9 influenza pneumonia were low-risk group.The PO_(2)/FiO_(2) were 143 mmHg,181 mmHg,73 mmHg,185 mmHg and 75 mmHg,respectively.The peripheral blood lymphocyte counts were0.6×10^(9)/L,0.22×10^(9)/L,0.70×10^(9)/L,0.29×10^(9)/L and 0.38×10^(9)/L.And the peripheral white blood cell count and platelet count of 2 patients were below normal range.Conclusions CURB-65 score and PSI score underestimated the mortality in patients with H7N9 influenza pneumonia,but PO_(2)2/FiO_(2) combined lymphocyte count is reliable predictor.