Fujita Jiro, Ohtsuki Yuji, Higa Hajime, Azuma Masato, Yoshinouchi Takeo, Haranaga Shusaku, Higa Futoshi, Tateyama Masao
Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases (The First Department of Internal Medicine), Faculty of Medicine, University of the Ryukyus, Japan.
Intern Med. 2014;53(12):1333-42. doi: 10.2169/internalmedicine.53.1174. Epub 2014 Jun 15.
The purpose of this study was to perform clinicopathological evaluations of patients with pure influenza A virus pneumonia.
We performed clinicopathological analyses of four cases of pure influenza A virus pneumonia. Patients Among the four cases, three were caused by the pandemic (H1N1) 2009 virus. Three patients were analyzed during autopsy, and one underwent transbronchial lung biopsy.
We suggest that the interval between influenza virus A pneumonia onset and our analysis affected the pathological findings. Diffuse alveolar damage was observed during the acute phase. After ten days, organizing pneumonia and marked proliferation of premature type II alveolar epithelium were observed. Clinically, intra-alveolar hemorrhage was observed in two patients. Pathologically, hyaline membrane formation and intra-alveolar hemorrhage were observed in all cases.
Severe epithelial damage was determined as the main mechanism of respiratory failure caused by influenza A virus pneumonia.
本研究旨在对纯甲型流感病毒肺炎患者进行临床病理评估。
我们对4例纯甲型流感病毒肺炎病例进行了临床病理分析。4例患者中，3例由2009年大流行（H1N1）病毒引起。3例患者在尸检时进行了分析，1例接受了经支气管肺活检。
我们认为甲型流感病毒肺炎发病至我们分析的时间间隔影响了病理结果。急性期观察到弥漫性肺泡损伤。10天后，观察到机化性肺炎和II型肺泡上皮细胞过早明显增生。临床上，2例患者出现肺泡内出血。病理上，所有病例均观察到透明膜形成和肺泡内出血。
严重上皮损伤被确定为甲型流感病毒肺炎所致呼吸衰竭的主要机制。
