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甲型H1N1流行性感冒(流感)多数进展为呼吸衰竭、MODS,少见合并血液系统疾病的报道。该文对2例甲型H1N1病毒感染相关性噬血细胞综合征患儿进行报道。2例患儿既往无其他基础疾病,均表现为发热、咳嗽,双肺可闻及湿啰音,X线胸片呈支气管肺炎改变,咽拭子H1N1病毒核酸检测(荧光定量PCR法)阳性。2例患儿均出现外周血白细胞减少、血小板水平下降,骨髓细胞学检查均示噬血细胞综合征骨髓象。予痰热清、大剂量丙种球蛋白治疗,2例患儿分别在用药后3~4 d体温降至正常,血常规约在10 d恢复正常。该文提示甲型H1N1流感病毒可在正常儿童诱发感染相关性噬血细胞综合征,及时骨髓细胞学检查有助于早期诊断,中成药联合大剂量丙种球蛋白可用于临床治疗。
Most of the H1N1 influenza (influenza) progression to respiratory failure, MODS, a rare combination of blood diseases reported. Two cases of influenza A virus-associated hemophagocytic syndrome were reported in this paper. None of the 2 children had any other underlying disease in the past with fever, cough, both lungs, and wet rales. The chest X-ray showed bronchopneumonia and the throat swab H1N1 virus nucleic acid (fluorescence quantitative PCR) was positive. 2 cases of peripheral blood leukopenia, decreased platelet levels, bone marrow cytology showed hemophagocytic bone marrow. To phlegm heat, high-dose gamma globulin treatment, 2 cases of children were 3 to 4 days after treatment, the body temperature dropped to normal, blood routine about 10 days to return to normal. The paper suggests that influenza A (H1N1) virus can induce infection-related hemophagocytic syndrome in normal children and timely bone marrow cytology is helpful for early diagnosis. Chinese patent medicine combined with high-dose gamma globulin can be used for clinical treatment.