Department of Radiology, Tangdu Hospital, Air Force Medical University, Xi'an, People's Republic of China.
Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Medical University, Xi'an, People's Republic of China.
Clin Respir J. 2023 Apr;17(4):277-285. doi: 10.1111/crj.13591. Epub 2023 Feb 1.
Critical H1N1 pneumonia patients usually have one of the symptoms such as respiratory failure, septic shock, multiple organ dysfunction, or other need for intensive care management, which are associated with high risk of mortality. It is essential to differentiate the severity of H1N1 pneumonia and take corresponding target treatments.
We aim to investigate the differences in clinical characteristics and chest computed tomography (CT) findings between severe and critical patients with H1N1 pneumonia.
A total of 27 patients diagnosed with H1N1 pneumonia from October 2018 to March 2019 were retrospectively analyzed, and the differences in clinical manifestations, laboratory tests, and chest CT findings between the severe group (15 patients) and the critical group (12 patients) were compared.
Frequency of dyspnea at rest was higher in critical group than that in severe group (P = 0.019). The neutrophil percentage was higher (P = 0.014) and the lymphocyte percentage was lower (P = 0.025) in critical compared with severe group. Bilateral lung involvement was the predominant pattern in both severe and critical patients, whereas the number of involved lobes in critical patients was more than that in severe patients (P = 0.024). Peripheral distribution was the predominant pattern in severe patients (40%), whereas more diffuse involvement of the lungs was observed in critical patients (83.30%). Ground-glass opacities and consolidation were the main CT findings in both groups, and prevalence of consolidation was higher in critical relative to severe group (83.30%).
Compared with severe patients, those with critical H1N1 pneumonia were more likely to present with dyspnea at rest and decreased lymphocyte percentage. Chest CT showed that diffuse bilateral involvement and higher prevalence of consolidation are associated with critical outcomes.
重症 H1N1 肺炎患者通常有呼吸衰竭、感染性休克、多器官功能障碍等一种或多种需要重症监护管理的症状，这些症状与高死亡率相关。区分 H1N1 肺炎的严重程度并采取相应的靶向治疗至关重要。
我们旨在研究重症和危重症 H1N1 肺炎患者的临床特征和胸部计算机断层扫描（CT）表现的差异。
回顾性分析 2018 年 10 月至 2019 年 3 月期间诊断为 H1N1 肺炎的 27 例患者，比较重症组（15 例）和危重症组（12 例）患者的临床表现、实验室检查和胸部 CT 结果的差异。
危重症组的静息呼吸困难频率高于重症组（P=0.019）。危重症组的中性粒细胞百分比较高（P=0.014），淋巴细胞百分比较低（P=0.025）。严重和危重症患者均以双侧肺受累为主，但危重症患者受累肺叶数多于严重组（P=0.024）。重症患者以周围分布为主（40%），而危重症患者则以弥漫性肺部受累为主（83.30%）。磨玻璃影和实变是两组患者的主要 CT 表现，实变在危重症患者中更为常见（83.30%）。
与重症患者相比，危重症 H1N1 肺炎患者更有可能出现静息呼吸困难和淋巴细胞百分比降低。胸部 CT 显示弥漫性双侧受累和实变发生率较高与危重症结局相关。
