重症与危重症甲型H1N1流感肺炎的影像学特点比较分析以及临床联系

目的：比较重症与危重症甲型 H1N1流感肺炎胸部CT影像表现。方法收集本院近3年来22例甲型H1N1流感肺炎患者的临床及影像资料,患者分为重症组(8例)和危重症组(14例)。回顾性分析2组之间的临床特点和实验室检查结果,以及比较胸部CT影像学特征的差别。结果危重症甲型 H1N1流感肺炎呼吸困难的表现更为明显。实验室检查结果中,重症组血中性粒细胞百分比为(63.4±18)%,危重症组为(83±9.9)%,重症组血淋巴细胞百分比为(24±13.3)%,危重症组为(11.7±7.3)%,2组间差异有统计学意义(z=-2.662,P=0.008；z=-2.246,P=0.025)。重症组中单侧多叶受累多见,7例(87.5%)胸部 CT 表现磨玻璃影；危重症组中病变多双肺受累,12例(85.7%)CT表现为磨玻璃影及实变影。危重症患者死亡率较高。结论血淋巴细胞减低,初期CT表现为双肺受累、肺内出现实变影的甲型 H1N1流感患者,易发展为危重症。

Imaging findings of severe and critical pulmonary infections with H1N1 and its correlation with clinical features

Objective To compare the differences of clinical and CT features between severe and critical pneumonia induced by H1N1.Methods The clinical and the imaging data of 22 patients with H1N1 infection in our hospital during the last 3 years were re-viewed.These patients were divided into severe group (8 cases)and critical group (14 cases).The differences of the clinical features and the laboratory results and the imaging findings between the two groups were analyzed retrospectively.Results Dyspnea was more prominent in critical group than that in severe group.In the laboratory results,the percentage of neutrophilic granulocyte was (63.4± 18)% in the severe group and (83±9.9)% in critical group.Meanwhile the lymphocytes percentage was (24±13.3)% in the severe group and (11.7±7.3)% in critical group;which exhibiting statistical defferences (z=-2.662,P=0.008;z=-2.246,P=0.025).In the severe group,CT showed patchy ground-glass opacity in 7 cases (87.5%)and patch shadows disseminating over unilateral lungs. In critical severe group,bilateral lungs were frequently involved,with consolidation and patchy ground-glass opacity seen in 1 2 cases (85.7%).The mortality in critical group were higher.Conclusion In H1N1 influenza pneumonia,decreased lymphocytes percentage, involved bilateral lungs and consolidation on CT may indicate critical severe pneumonia.