甲型流感病毒合并肺部感染与非病毒性肺部感染的表现及治疗分析  

Manifestation and Treatment of Influenza A Virus with Pulmonary Infection and Non Viral Lung Infection

作　　者：李晶晶[1] 刘晓东[1] 肖峰[1] 宋杨[1] 季伟[1] 周橙 LI Jing-jing;LIU Xiao-dong;XIAO Feng;SONG Yang;JI Wei;ZHOU Cheng(Department of Emergency,Nanjing Hospital Affiliated to Nanjing Medical Uni versity/Nanjing First Hospital,Nanjing,Jiangsu,211100,China)

机构地区：[1]南京医科大学附属南京医院/南京市第一医院急诊科

出　　处：《现代生物医学进展》2019年第17期3366-3369,共4页Progress in Modern Biomedicine

基　　金：江苏省临床医学科技专项课题（BL20152361)

摘　　要：目的:通过与非病毒性肺部感染对比,分析甲型流感病毒合并肺部感染患者的常见临床实验检查及治疗效果,为经验性治疗甲型流感病毒提供一定依据。方法:选择2017年11月至2018年4月期间在我科接受治疗的已确诊存在甲型流病毒合并肺部感染(A组)及非病毒性肺感染(B组)各25例,对于确诊的甲型流感患者给予奥司他韦抗病毒治疗一周外,两组均正常给予常规抗感染治疗,对比两组患者的炎症指标白细胞计数、中性粒细胞比例、C-反应蛋白及治疗天数、住院天数、症状消失时间、不良反应发生率。结果:两组患者的CT检查表现无统计学差异(P>0.05),A组患者的白细胞计数水平明显低于B组,差异有统计学意义(P<0.05),而两组患者的中性粒细胞比例及C反应蛋白水平差异无统计学意义(P>0.05)。两组患者的治疗天数及住院天数差异均无统计学意义(P>0.05)。两组患者在体温恢复正常时间、咳嗽消失时间、肺部湿罗音消失时间、气促消失时间等比较差异无统计学意义(P>0.05)。A组不良反应发生率为16.00%(4/25),B组不良反应发生率为12.00%(3/25),组间差异无统计学意义(P>0.05)。结论:甲型病毒性肺部感染常表现为血常规未见异常,常伴发不同程度炎症反应,除常规抗感染治疗外,口服抗病毒药物奥司他韦可促进疾病转归。Objective: To analyze the common clinical examination and therapeutic effect of influenza A virus with pulmonary infection by comparing with non-viral pulmonary infection, so as to provide a basis for empirical treatment of influenza A virus. Methods:25 patients with confirmed influenza A virus infection with lung infection(group A) and 25 patients with non-viral pulmonary infection(group B) were selected in our hospital from November 2017 to April 2018. Patients with confirmed influenza A were given oseltamivir antiviral therapy for one week, and both groups were given routine antiviral therapy. The inflammation indexes such as white blood cell count, neutrophil ratio, C-reactive protein and treatment day, hospitalization day, symptoms disappearing time and adverse reactions were compared between the two groups. Results: There was no significant difference in CT findings between the two groups(P>0.05). The white blood cell count in group A was significantly lower than that in group B(P<0.05). There was no significant difference in neutrophil ratio and C-reactive protein level between the two groups(P>0.05). There was no significant difference in the treatment days and hospitalization day between the two groups(P>0.05). There was no significant difference between the two groups in the body temperature returned to normal, cough disappear time, disappearance time of lung rales and shortness of breath(P>0.05). The incidence of adverse reactions was 16.00%(4/25) in group A and 12.00%(3/25) in group B, There was no significant difference between the two groups(P>0.05).Conclusion: Influenza A virus with pulmonary infection is often manifested as normal blood routine, often accompanied by varying degrees of inflammation, in addition to conventional anti-infective treatment, oral oseltamivir can promote the prognosis of the disease.

关 键 词：甲型流感病毒 肺部感染 非病毒性肺部感染 表现 治疗 

分 类 号：R511.7[医药卫生—内科学] R563.1[医药卫生—临床医学]