人感染H7N9禽流感与甲型H1N1流感重症肺炎的临床及CT影像学特点分析

摘要

目的 通过对人感染H7N9禽流感与甲型H1N1流感重症肺炎的临床及CT影像学特点的分析及探讨,为以后的临床工作,提供一定价值的参考.方法 选择获得临床确诊的人感染H7N9禽流感患者15例和甲型H1N1流感重症肺炎患者25例作为研究对象,对患者的临床表现、并发症以及治疗转归情况进行回顾性分析,对2组患者进行CT影像学检查,并对检查结果展开对比分析.结果 经对比发现,H7N9患者气促、呼吸困难、急性呼吸窘迫综合征发生率,入住ICU患者所占比例均显著高于H1N1患者(P<0.05);H7N9组患者有创机械通气治疗率、死亡率显著高于H1N1组患者(P<0.05),好转率显著低于H1N1组(P<0.05);H7N9患者CT检查发现小叶间隔变厚、胸腔积液、网格状密度影表现高于H1N1患者(P<0.05).结论 人感染H7N9禽流感患者的基础疾病较H1N1患者多,并且病情发展迅速,死亡率高,经CT检查可以对H7N9和H1N1患者的影像特征进行客观反映,对于临床治疗具有重要的指导意义.%Objective To analyze and discuss the clinical and CT imaging features of severe pneumonia in human infection with avian influenza A (H7N9) and influenza A (H1N1), so as to provide some valuable references for future clinical work. Methods For clinical diagnosis of avian influenza H7N9 infection patients and 15 cases of influenza a H1N1 patients with severe pneumonia in 25 cases as the research object, the clinical manifestations of patients, complications and treatment outcomes were retrospectively analyzed, 2 groups of patients were CT imaging examination, and the inspection results of comparative analysis. Results The results revealed that H7N9 patients with shortness of breath, dyspnea, acute respiratory distress syndrome incidence in ICU patients were significantly higher than the proportion of patients with H1N1(P<0.05);H7N9 group of patients with invasive mechanical ventilation and mortality rate was significantly higher than that in H1N1 group(P<0.05),the improvement rate was significantly lower than that of H1N1 group(P<0.05);H7N9 patients with CT showed interlobular septal thickening, mesh density, pleural effusion was higher than that of H1N1 patients(P<0.05).Conclusion The basic diseases of people infected with H7N9 avian influenza are more than those of H1N1 patients, and the disease develops rapidly and the mortality rate is high. The CT examination can objectively reflect the image features of H7N9 and H1N1 patients, and has important guiding significance for clinical treatment.