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目的:评价2009甲型H1N1流感患者长期预后的情况。方法:对2009甲型H1N1流感患者进行3 a随访,对既往病历资料进行回顾性分析,随访时进行病史采集、体格检查、T细胞亚群、胸部CT、肺功能、6分钟步行试验检查,对所有资料进行描述性分析。结果:共纳入12例患者,其中轻症、重症、危重症各4例,随访时平均年龄42.3岁,发病至随访的间隔24~46个月,平均39.1个月(3.26 a)。随访时复查胸部CT提示所用重症、危重症患者,均存在不同程度的肺部炎症,以间质性炎症为主。随访时共9例患者进行肺功能检测,其中轻症3例,重症4例,危重症2例,其中67%的患者存在不同程度肺功能异常,以轻度限制性通气功能障碍为主。所用患者在随访时均进行6分钟步行试验检测,1例危重症患者6分钟步行试验I级,1例重症患者6分钟步行试验III级,其他患者6分钟步行试验分级均为IV级。结论:2009甲型H1N1流感患者轻症、重症、危重症在3 a随访时均可能存在不同病情程度肺部影像学异常以及肺功能异常,以间质病变及限制性通气功能障碍为主,应重视长期随访,若进行积极的中医药干预有望改善患者的长期预后。
Objective: To evaluate the long-term prognosis of patients with 2009 H1N1 influenza. Methods: The 2009 H1N1 influenza patients were followed up for 3 years. The medical records were retrospectively analyzed. The patients were followed up for medical history, physical examination, T cell subsets, chest CT, lung function and 6-minute walk test. All data descriptive analysis. Results: A total of 12 patients were enrolled. Among them, 4 were mild, severe and critically ill. The mean age at follow-up was 42.3 years. The average duration of follow-up was 24-46 months (mean 39.1 months, 3.26 days). Follow-up review of chest CT tips used in critically ill, critically ill patients, there are varying degrees of lung inflammation, mainly interstitial inflammation. A total of 9 patients were followed up for pulmonary function tests. Among them, 3 were mild, 4 were severe, and 2 were critically ill. Among them, 67% had pulmonary dysfunction to some extent, with mild restrictive ventilation dysfunction. Patients were followed up for 6 minutes walk test test, a critically ill patients 6-minute walk test grade I, a case of critically ill patients 6-minute walk test grade III, other patients 6-minute walk test grading are grade IV. CONCLUSIONS: Patients with mild, severe and critical illness of 2009 H1N1 influenza group may have different degrees of pulmonary dysplasia and pulmonary dysfunction at 3 years of follow-up. Interstitial lesions and restrictive ventilatory dysfunction should be the main symptoms. Emphasis on long-term follow-up, if active Chinese medicine is expected to improve the long-term prognosis of patients.