Chippirraz Elisabet Lerma, Sorlí Lluisa, Montero Milagro, Mas Virgina, Granados Eduardo López, Vilaplana Carles, Alvarez-Lerma Francisco, Knobel Hernando, Horcajada Juan Pablo
Servicio de Medicina Interna-Enfermedades Infecciosas, Hospital del Mar, Barcelona, Spain.
Rev Esp Quimioter. 2011 Dec;24(4):204-8.
On April 2009 a new A (H1N1) influenza virus was identified with a higher incidence of severe outcome in younger people, most of them with pneumonia. The objective of our study was to identify the predictive risk factors of pneumonia in patients with the new A (H1N1) influenza virus infection.
Prospective cohort study of adults infected with the new A (H1N1) influenza virus, admitted in a universitary hospital, from june 2009 to January 2010. Pneumonia was defined as the presence of any pulmonary infiltrate of any distribution with no other evident cause, in the chest radiography. A comparative analysis was made with patients with A (H1N1) influenza without pneumonia.
281 patients with influenza A (H1N1) were treated. Thirty of them (10.6%) had pneumonia and 11 (3.9%) required intensive care. The global mortality was 0.7%. For the comparative analysis, 42 patients with influenza A (H1N1) without pneumonia were analysed (20 hospitalized and 22 nonhospitalised). In the multivariate analysis, obesity (BMI>30), (OR: 3.8; IC 95%: 0.99-15.0), time since symptom onset until hospital admission (OR 1.34; IC 95% 1.04-1.72), serum C reactive protein levels (OR:1.10; IC 95%: 0.98-1.24) and serum IgG2 levels (OR:1.08; IC 95%: 1.0- 1.01), were identified as independent risk factors for pneumonia.
Obesity, delay in medical care and higher levels of C reactive protein and IgG2 were predictive factors for pneumonia in adult patients with A (H1N1) influenza infection.
2009年4月，一种新型甲型（H1N1）流感病毒被确认，该病毒在年轻人中导致严重后果的发生率更高，其中大多数人患有肺炎。我们研究的目的是确定新型甲型（H1N1）流感病毒感染患者发生肺炎的预测风险因素。
对2009年6月至2010年1月在一家大学医院收治的感染新型甲型（H1N1）流感病毒的成年人进行前瞻性队列研究。肺炎的定义为胸部X线检查显示存在任何分布的肺部浸润且无其他明显病因。对甲型（H1N1）流感无肺炎患者进行了对比分析。
281例甲型（H1N1）流感患者接受了治疗。其中30例（10.6%）患有肺炎，11例（3.9%）需要重症监护。总体死亡率为0.7%。为进行对比分析，分析了42例甲型（H1N1）流感无肺炎患者（20例住院，22例未住院）。在多变量分析中，肥胖（BMI>30）（比值比：3.8；95%置信区间：0.99 - 15.0）、症状出现至入院的时间（比值比1.34；95%置信区间1.04 - 1.72）、血清C反应蛋白水平（比值比：1.10；95%置信区间：0.98 - 1.24）和血清IgG2水平（比值比：1.08；95%置信区间：1.0 - 1.01）被确定为肺炎独立风险因素。
肥胖、就医延迟以及C反应蛋白和IgG2水平升高是甲型（H1N1）流感感染成年患者发生肺炎的预测因素。
