Clinical analysis of 75 severe and critical patients with novel influenza A(H1N1)

DAI Bing; WEN Hua; TAN Wei; SUN Long-feng; ZHAO Hong-wen; KANG Jian

Abstract：Objective To analyze the clinical features of patients with severe and critical influenza A (H1N1),and to discuss the methods for its diagnosis and treatment.Methods The clinical features,laboratory findings,and the image data of 75 influenza A(H1N1)patients,who were admitted to the First Affiliated Hospital of China Medical University during October 24,2009-December 12,2009,were retrospectively analyzed.Results The patients included 29 severe cases and 46 critical cases,54 males and 21 females,with an age range of 18～66 years and a mesh of 42.4 years old.Sixteen patients had definite contact history;the mean latency was 3.5 days.The most common initial symptoms included fever(56.0%),bloody sputum(20.0%)and rales(90.7%).Blood routine showed that 78.7%of patients had increased GRAN,74.7%had increased lymphocyte ratio,56.7%had hypoalbuminemia,58.2%had increased LDH.Analysis of peripheral T lymphocyte subgroup showed that 57.1%patients had decreased CD4.However,10.7%patients had no fever in the course of disease.The major findings of lung CT were multiple,bilateral patchy opacity and ground slass opacity.The major findings of pulmonary function test were restrictive ventilatory functional disturbance and severe diflusion dysfunction.Twentythree cases had ARDS(10 death cases all had both ARDS and MODS).Conclusion Early identification of severe and critical influenza A(H1N1)patients and early treatment with oseltamivir are the keys for diagnosis and treatment;and comprehensive therapy and supporting therapy can achieve better therapeutic effects.