Riquelme Raúl, Riquelme Mauricio, Torres Antoni, Rioseco Maria Luisa, Vergara José Antonio, Scholz Luis, Carriel Andrea
Puerto Montt Regional Hospital, Puerto Montt, Chile.
Emerg Infect Dis. 2003 Nov;9(11):1438-43. doi: 10.3201/eid0911.020798.
We analyzed data from 25 consecutive patients with hantavirus pulmonary syndrome (HPS) admitted to the Puerto Montt and Osorno Regional Hospitals, southern Chile, from 1997 to 2001, emphasizing epidemiologic, clinical, radiographic, treatment, and laboratory aspects. Hemorrhage was frequent (64%), and 48% of patients showed alterations in renal function. Ten patients died (40%). We identified three groups of patients, which included the following: 1) those with the least severe form who had prodromic symptoms without pulmonary involvement; 2) those with moderate illness who had interstitial pulmonary infiltrates, usually needed supplemental nasal oxygen, were hemodynamically stable, and had an APACHE II <12 (none of whom died); and 3) those with the severe form who required mechanical ventilation, frequently had hemodynamic instability (93%), experienced a high mortality rate (77%), and had an APACHE II >12. Mild forms of HPS also exist, which are poorly known; the symptoms could be confounded with those of other viral diseases, leading to underdiagnosis.
我们分析了1997年至2001年期间连续入住智利南部蒙特港和奥索尔诺地区医院的25例汉坦病毒肺综合征（HPS）患者的数据，重点关注流行病学、临床、影像学、治疗及实验室方面的情况。出血情况较为常见（64%），48%的患者出现肾功能改变。10例患者死亡（40%）。我们将患者分为三组，具体如下：1）症状最轻的一组，有前驱症状但无肺部受累；2）病情中等的患者，有间质性肺浸润，通常需要经鼻吸氧，血流动力学稳定，急性生理与慢性健康状况评分系统（APACHE II）<12（无一例死亡）；3）病情严重的患者，需要机械通气，常出现血流动力学不稳定（93%），死亡率高（77%），APACHE II>12。轻度HPS病例也存在，但鲜为人知；其症状可能与其他病毒性疾病混淆，导致诊断不足。
