MMWR Morb Mortal Wkly Rep. 2009 Jul 17;58(27):749-52.
In April 2009, CDC reported the first two cases in the United States of human infection with a novel influenza A (H1N1) virus. As of July 6, a total of 122 countries had reported 94,512 cases of novel influenza A (H1N1) virus infection, 429 of which were fatal; in the United States, a total of 33,902 cases were reported, 170 of which were fatal. Cases of novel influenza A (H1N1) virus infection have included rapidly progressive lower respiratory tract disease resulting in respiratory failure, development of acute respiratory distress syndrome (ARDS), and prolonged intensive care unit (ICU) admission. Since April 26, communitywide transmission of novel influenza A (H1N1) virus has occurred in Michigan, with 655 probable and confirmed cases reported as of June 18 (Michigan Department of Community Health [MDCH], unpublished data, 2009). This report summarizes the clinical characteristics of a series of 10 patients with novel influenza A (H1N1) virus infection and ARDS at a tertiary-care ICU in Michigan. Of the 10 patients, nine were obese (body mass index [BMI] >or=30), including seven who were extremely obese (BMI =40); five had pulmonary emboli; and nine had multiorgan dysfunction syndrome (MODS). Three patients died. Clinicians should be aware of the potential for severe complications of novel influenza A (H1N1) virus infection, particularly in extremely obese patients.
2009年4月，美国疾病控制与预防中心（CDC）报告了美国首例两例新型甲型H1N1流感病毒感染病例。截至7月6日，共有122个国家报告了94,512例新型甲型H1N1流感病毒感染病例，其中429例死亡；在美国，共报告了33,902例病例，其中170例死亡。新型甲型H1N1流感病毒感染病例包括迅速进展的下呼吸道疾病，导致呼吸衰竭、急性呼吸窘迫综合征（ARDS）的发生以及在重症监护病房（ICU）的长时间住院。自4月26日以来，密歇根州已出现新型甲型H1N1流感病毒的社区传播，截至6月18日报告了655例疑似和确诊病例（密歇根州社区卫生部[MDCH]，未发表数据，2009年）。本报告总结了密歇根州一家三级护理ICU中10例新型甲型H1N1流感病毒感染并伴有ARDS患者的临床特征。这10例患者中，9例肥胖（体重指数[BMI]≥30），其中7例极度肥胖（BMI =40）；5例有肺栓塞；9例有多器官功能障碍综合征（MODS）。3例患者死亡。临床医生应意识到新型甲型H1N1流感病毒感染出现严重并发症的可能性，尤其是在极度肥胖的患者中。
