Pandemic (H1N1) 2009 influenza.
Pandemic (H1N1) 2009 influenza.
复制标题
大流行（H1N1）2009流感。
DOI：
10.1093/bja/aep375
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发表时间：
2010-03
影响因子：
9.8
通讯作者：
Khan Z
中科院分区：
文献类型：
--
作者：
Patel M;Dennis A;Flutter C;Khan Z
2009年H1N1大流行流感严重病例的临床情况与季节性流感流行期间的疾病模式明显不同，因为许多受影响的人都是以前健康的年轻人。目前的预测估计，在大流行期间，12%-30%的人口将患上临床流感(季节性流感的这一比例为5%-15%)，其中4%的患者需要住院治疗，五分之一的患者需要重症护理。本文就其背景、临床表现、诊断和治疗作一综述。对免疫和抗病毒药物的作用进行了讨论。2009年第一波大流行(H1N1)流感的经验表明，一些受感染的患者病情危重，需要重症监护入院。这些患者迅速发展为严重的进行性呼吸衰竭，通常与其他器官衰竭有关，或明显恶化潜在的呼吸道疾病。回顾了这些患者的重症监护管理及其对资源的影响。在相对较短的时间内为应对2009年大流行(H1N1)流感提供了一系列机构的指导。疾病的严重程度有可能发生变化，特别是在病毒发生突变的情况下。临床医生必须为意外情况做好准备，并继续分享他们的经验，以最大限度地提高患者的预后。
The clinical picture in severe cases of pandemic (H1N1) 2009 influenza is markedly different from the disease pattern seen during epidemics of seasonal influenza, in that many of those affected were previously healthy young people. Current predictions estimate that, during a pandemic wave, 12–30% of the population will develop clinical influenza (compared with 5–15% for seasonal influenza) with 4% of those patients requiring hospital admissions and one in five requiring critical care. This review covers the background, clinical presentation, diagnosis, and treatment. The role of immunization and antiviral drugs is discussed. Experience from the first wave of pandemic (H1N1) 2009 influenza suggests that a number of infected patients become critically ill and require intensive care admission. These patients rapidly develop severe progressive respiratory failure which is often associated with failure of other organs, or marked worsening of underlying airways disease. The critical care management of these patients and the implications for resources is reviewed. Guidance from a range of bodies has been produced in a relatively short period of time in response to pandemic (H1N1) 2009 influenza. Disease severity has the potential to change, especially if there is virus mutation. Clinicians must be prepared for the unexpected and continue to share their experiences to maximize patient outcomes.
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