流感病毒性肺炎治疗研究进展  

Advance in research on treatment of influenza viral pneumonia

作　　者：周春霞 孙婧[2] 徐凤琴[2] 江山平[3] ZHOU Chun-xia;SUN Jing;XU Feng-qin;JIANG Shan-ping(The Seventh Affiliated Hospital,Sun Yat-Sen University,Shenzhen,Guangdong 518107,China;不详)

机构地区：[1]中山大学附属第七医院呼吸与危重症医学科,广东深圳518107 [2]中山大学孙逸仙纪念医院医院感染管理办公室,广东广州510120 [3]中山大学孙逸仙纪念医院医院呼吸与危重症医学科,广东广州510120

出　　处：《中华医院感染学杂志》2020年第2期302-307,共6页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81670022)。

摘　　要：流行性感冒(以下简称为流感)是由流感病毒引起的一种急性呼吸道传染病。流感病毒感染人体后,可以诱发细胞因子风暴,导致全身炎症反应,严重者可出现急性呼吸窘迫综合征(ARDS)、休克或多脏器功能衰竭。本文综述了近年来流感病毒性肺炎治疗方面的进展。神经氨酸酶抑制剂是目前有效抗流感病毒的唯一选择,联合抗病毒治疗的疗效和安全性仍然存有争议。理想的免疫调节使流感病毒引起的机体免疫反应可控,既达到清除病毒的目的,又不至于引起过度的组织损伤。重视早期诊断并积极治疗流感后继发的耐甲氧西林金黄色葡萄球菌(MRSA)感染及侵袭性肺曲霉菌病(IPA),是减少流感病毒性肺炎治疗失败的重要环节。机械通气并发症、自发性气胸或纵膈气肿在流感病毒性肺炎患者中发生率较高,而越来越多临床证据支持早期使用体外膜肺氧合(ECMO)治疗。Influenza, known as flu, is a kind of acute respiratory infectious disease caused by influenza virus.When people are infected with influenza virus, it may trigger the cytokine storm and lead to systemic inflammatory response syndrome, and those critically severe cases may have acute respiratory distress syndrome(ARDS),shock or multiple organs failure.The progress of treatment of the influenza viral pneumonia that has been achieve in the past few years is reviewed in the article.At present, neuraminidase inhibitor is the only and effective choice for treatment of the influenza virus, and the efficacy and safety of combined antiviral therapies remains controversial issues.Ideal immunoregulation may make the immunoreaction induced by influenza virus controllable, which contributes to the eradication of virus and prevent excessive tissue damage.It is an important link to focus on the early diagnosis and actively treat the secondary methicillin-resistant Staphylococcus aureus(MRSA) infection and invasive pulmonary aspergillosis(IPA) that are induced by the influenza so as to raise the rate of successful treatment of influenza viral pneumonia.The incidence of mechanical ventilation-related complications, spontaneous pneumothorax or mediastinal emphesema is high among the patients with influenza viral pneumonia, while, a growing number of clinical evidence tends to be application of extracorporeal membrane oxygenation(ECMO) in early stage.

关 键 词：流感病毒 重症肺炎 免疫调节 体外膜肺氧合 

分 类 号：R563.1[医药卫生—呼吸系统]