Yatera Kazuhiro, Yamasaki Kei, Kawanami Toshinori, Tokuyama Susumu, Ogoshi Takayuki, Kouzaki Minako, Nagata Shuya, Nishida Chinatsu, Yoshii Chiharu, Mukae Hiroshi
Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan.
Intern Med. 2011;50(6):601-5. doi: 10.2169/internalmedicine.50.4604. Epub 2011 Mar 15.
We report a case of acute respiratory distress syndrome (ARDS) after influenza A infection who was successfully treated with combined treatment including direct hemoperfusion with polymyxin B-immobilized fiber (PMX-DHP) column. A 56-year-old Japanese man was admitted to our hospital in January 2010 because of progressive dyspnea, hypoxemia, fever and bilateral diffuse infiltration on chest radiograph after pandemic influenza A infection. His chest computed tomography showed diffuse and patchy bilateral ground-glass opacities, and we diagnosed ARDS after influenza A infection. The patient was successfully treated with PMX-DHP in addition to the treatment with oseltamivir, corticosteroid, sivelestat and antibiotics with mechanical ventilation, and the patient recovered with only minor pulmonary fibrotic change. Although the efficacy of PMX-DHP treatment in patients with acute lung injury (ALI)/ARDS after influenza virus infection is not well established, this treatment could be a possible therapeutic modality in treating the patients with this disease.
我们报告一例甲型流感感染后发生急性呼吸窘迫综合征（ARDS）的病例，该患者接受了包括使用多粘菌素B固定纤维柱直接血液灌流（PMX-DHP）在内的联合治疗并成功治愈。一名56岁的日本男性于2010年1月因甲型流感大流行感染后出现进行性呼吸困难、低氧血症、发热以及胸部X线片显示双侧弥漫性浸润而入住我院。他的胸部计算机断层扫描显示双侧弥漫性斑片状磨玻璃影，我们诊断为甲型流感感染后ARDS。该患者除接受奥司他韦、皮质类固醇、西维来司他和抗生素治疗以及机械通气外，还成功接受了PMX-DHP治疗，患者康复后仅遗留轻微的肺纤维化改变。尽管PMX-DHP治疗对流感病毒感染后急性肺损伤（ALI）/ARDS患者的疗效尚未明确，但这种治疗可能是治疗该疾病患者的一种可行治疗方式。
