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SKL Respir Dis 重症流感、禽流感 上海市公共卫生临床中心 复旦大学附属华山医院 卢洪洲 卢洪洲[email protected]
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SKL Respir Dis [email protected]
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SKL Respir Dis H7N9
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SKL Respir Dis 87 2013-2-26 2013-3-4 1. 2. 3. 1 3
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SKL Respir Dis 85 /
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SKL Respir Dis D- (2013-03-01)5.73mg/L (2013-03-03) 27.41mg/L
(2013-02-27) :501U/L, :27U/L, :480U/L (2013-03-01) :311U/L, :28U/L,
:1929U/L (2013-03-03) :236U/L, :17U/L, :1751U/L
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SKL Respir Dis CRP (2013-02-27)114mg/L (2013-03-03) 95mg/L
(2013-02-27) :6.7mmol/L, :74mol/L, :203mol/L (2013-03-01)
:8.1mmol/L, :73mol/L, :206mol/L (2013-03-03) :9.6mmol/L, :95mol/L,
:117mol/L C - (2013-02-27):0.81ng/mL
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SKL Respir Dis 2013-03-04 (2013-02-28) (2013-02-27) :31U/L,
:77U/L, :6.7mol/L, :4.8mol/L, :12.2mol/L, :55.8g/L, :30.7g/L,
:25.1g/L, (2013-03-01) :50U/L, :17.3mol/L, :109U/L (2013-03- 03)
:58U/L, :23.6mol/L, :73U/L
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SKL Respir Dis (2013-02-27) :3.7mmol/L, :140mmol/L, :101mmol/L,
:1.9mmol/L, :0.96mmol/L, :0.96mmol/L (2013-02-27)8.6mmol/L
(2013-03-03):8mm/h
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SKL Respir Dis - (2013-02-26) PH:7.48,BEb:-
0.1mEq/L,PO2:54mmHg,PCO2:29mmHg (2013-02-27)
PH:7.42,BEb:4.8mEq/L,PO2:26mmHg,PCO2: 45mmHg (2013-02-28)
PH:7.52,BEb:6mEq/L,PO2:52mmHg,PCO2: 34mmHg
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SKL Respir Dis (2013-02-27) :4.67*10^9/L, :4.11*10^9/L, :88.1%,
:11.3% :131g/L, :4.38*10^12/L, :78*10^9/L, (2013-03-03)
:16.8*10^9/L, :15.52*10^9/L, :92.4%, :4.9% :126g/L, :4.22*10^12/L,
:89*10^9/L,
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SKL Respir Dis I(2013-03-01):0.05ng/mL (2013-03-03) I:0.05ng/mL
(2013-03-01) INR:1.17,PT:13.4 ,TT:23.5 ,APTT:38.3 ,FIB:1.85g/L
(2013-03-03) INR:1.26,PT:14.4 ,TT:19.2 ,APTT:38.7 ,FIB:1.82g/L
(2013-02-27):0.327ng/mL B (2013-03- 03):7480pg/mL
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SKL Respir Dis + + 2 27 + + 3 4
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SKL Respir Dis
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SKL Respir Dis
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SKL Respir Dis
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SKL Respir Dis
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SKL Respir Dis
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SKL Respir Dis
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SKL Respir Dis ++ IgM OD 0.055 H1N1 -- 2009H1N1 -- H3N2 -- H5
-- IgG OD 0.877 H7 -- H9 -- SARS CoV -- --
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SKL Respir Dis -- IgM OD 0.117 H1N1 -- 2009H1N1 -- H3N2 -- H5
-- IgG OD 2.057 H7 -- H9 -- SARS CoV -- --
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SKL Respir Dis -- IgM OD 0.01 H1N1 -- 2009H1N1 -- H3N2 -- H5 --
IgG OD 0.934 H7 -- H9 -- SARS CoV -- --
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SKL Respir Dis 27 2013-03-04 2013-03-10 I 5 2
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SKL Respir Dis
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SKL Respir Dis T 39.40 P 100 / R 20 / Bp 120/80mmHg
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SKL Respir Dis (2013-03-05)HbsAg:>
250.00(+)IU/mL,HBsAb:(-),HbeAg:(- ),HBeAb:(+),HBcAb:(+) HIV
(2013-03-05) (2013-03-08) C4:0.22g/L,
CH50:35U/ml,IgG:11.5g/L,IgA:2.23g/L,IgM:0.59g/L, C3:0.59g/L (
)(2013-03-05) 6.6mmol/L (2013-03-08) :30.41ng/mL
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SKL Respir Dis (2013-03-05) :606U/L, :27U/L, :435 (2013-03-06)
:>1600U/L, :37U/L, :1983U/L (2013-03-09) :359U/L, :33U/L,
:1377U/LU/L (2013-03-10) :325U/L, :41U/L, :579U/L (2013-03-05)
ALT:41U/L, AST:58U/L, TBIL:6.5mol/L, (2013-03-07) ALT:48U/L,
AST:106U/L, TBIL:6.7mol/L
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SKL Respir Dis (2013-03-05) :3.8mmol/L, :72mol/L, :169mol/L,
(2013-03-06) :2.9mmol/L, :53mol/L, :117mol/L (2013-03-07)
:4.6mmol/L, :51mol/L, :77mol/L D- (2013-03-05) 4.3mg/L (2013-03-06)
5.62mg/L CRP (2013-03-05) 32mg/L (2013-03-10) CRP:22mg/L
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SKL Respir Dis (2013-03-04)
PH:7.44,PHNR:7.423,SB:25.8mEq/L,BEb:2.5
mEq/L,PO2:49mmHg,BBp:50.9mEq/L,PCO2 :38mmHg,P50:25.7mmHg,
:15.8g/dl,AB:25.8mEq/L,TCO2:27mmol/L (2013-03-08)
PH:7.55,PHNR:7.473,SB:29mEq/L,BEb:6.
8mEq/L,PO2:66mmHg,BBp:53.1mEq/L,P CO2:32mmHg,P50:22.8mmHg,
:11g/dl,AB:28mEq/L,TCO2:29mmol/L
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SKL Respir Dis (2013-03-05) :2.1**10^9/L, :1.9**10^9/L, :86.8%,
:10.5%, :143g/L, :4.7**10^12/L, :58**10^9/L, (2013-03-10)
:22.5**10^9/L, :20.02**10^9/L, :89%, :10.2%, :157g/L,
:247**10^9/L
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SKL Respir Dis + 3 6 30 / SPO 262% 132 / ICU
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SKL Respir Dis :2932U/L, ( :47U/L, :2327U/L :1.41**10^9/L,
:0.19**10^9/L, :4.69**10^12/L, :1.64**10^9/L, :86%, :11.6%
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SKL Respir Dis + + ICU 3 10 11 30 37 / 70/35mmHg 42% 12 10
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SKL Respir Dis
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SKL Respir Dis
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SKL Respir Dis
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SKL Respir Dis
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SKL Respir Dis
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SKL Respir Dis
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SKL Respir Dis
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SKL Respir Dis ++ IgM OD 0.055 H1N1 -- 2009H1N1 -- H3N2 -- H5
-- IgG OD 0.877 H7 -- H9 -- SARS CoV -- --
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SKL Respir Dis (MODS) , , , , : , /
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SKL Respir Dis (ECMO) 7.1-8.31 Australia and New Zealand 15 ICU
ARDS 133 1/3 ECMO ECMO 68 , 26.6-43.1 y, M 50% PaO2/FiO2 34.4
(26.6-43.1), PEEP 18 (15-20) ECMO 10 (7-15) d ICU 48 , 21% JAMA,
2009, Oct
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SKL Respir Dis
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SKL Respir Dis
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