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流行性感冒併發肺炎的臨床研究
Clinical features of influenza associated pneumonia
摘要
目的：分析流行性感冒併發肺炎的臨床特征和預後，以提高對流行性感冒併肺炎的臨床救治水平。方法：收集2016年1月～2018年3月在本院确診的流行性感冒併肺炎住院患者120例作為研究對象。結果：患者年齡18歲～99歲，平均年齡（63.4±20.8）歲，76例（63.3%）為≥60歲的中老年人。72.5%的患者至少合併1種基礎疾病。快速流感篩查試驗的敏感度為93.3%，高於流感病毒分型測試敏感度80.0%（X^2=7.68,P<0.01）。白細胞計數<4×10^9/L佔13.3%；白細胞>10×10^9/L佔45.8%，淋巴細胞<1×10^9/L佔50%。合併細菌感染的陽性比例為26.8%。120例患者中死亡6例，病死率為5%。嚴重心、肺疾病及腫瘤等慢性疾病，肺炎範圍、淋巴細胞計數異常在重症組更常見。結論：合併嚴重心、肺疾病、惡性腫瘤等慢性疾病，病變範圍廣，淋巴細胞計數異常等情況提示患者預後不良。
並列摘要
Objective: To analyze the clinical features and prognosis of influenza related pneumonia cases, in order to improve the clinical management of influenza related pneumonia. Methods: 120 patients confirmed with influenza viral pneumonia admitted to Kiang Wu Hospital from 2016-01-01 to 2018-03-03 were included in the study. Results: Patients age ranged from 18 to 99 years, mean age was 63.4 (±20.8) years old, with 76 cases (63.6%) older than 60 years. 72.5% of the patients had one or more underlying comorbidities. The sensitivity of rapid influenza antigen test was 93.3%, which was higher compared to80.0% of the real time reverse-transcriptase polymerase chain reaction test (X^2=7.68, P<0.01). WBC was lower than 4×10^9/L in13.3% of the patients and higher than 10×10^9/L in 45.8% of the patients.50% of the patients showed lymphocyte count lower than1×10^9/L. Concomitant bacterial infections was found in 26.8% patients. Among the 120 cases 6 patients died, mortality rate was 5%. Influenza related severe pneumonia was associated with chronic conditions as severe cardiopulmonary diseases and tumors, widespread affected lung area and abnormal lymphocyte count. Conclusion: Poor prognosis is suggested in patients with comorbid severe cardiopulmonary conditions, malignancy, greater affected lesion area and abnormal lymphocyte count.