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2013, vol. 70, br. 2, str. 155-162
Kliničke karakteristike, terapije i ishodi lečenja gripa A (H1N1) 2009. kod bolesnika koji su ležali u Klinici za infektivne bolesti u Novom Sadu
aKlinički centar Vojvodine, Klinika za infektivne bolesti, Novi Sad
bInstitut za plućne bolesti, Sremska Kamenica
cUniverzitet u Novom Sadu, Poljoprivredni fakultet, Departman za veterinarsku medicinu

e-adresagrozdanacanak@gmail.com
Sažetak
Uvod/Cilj. Infekcije uzrokovane virusom gripa A (H1N1) u većini slučajeva manifestuju u blagom respiratornom simptomatologijom. Ipak, neki bolesnici zahtevaju hospitalizaciju u jedinicama intenzivne nege (intensive care units - ICU). Cilj rada bio je prikazivanje kliničkih i laboratorijskih karakteristika bolesnika sa gripom A (H1N1) 2009, primenjene antivirusne terapije, ishoda bolesti i faktora rizika od razvoja teškog oblika bolesti. Metode. Studijom su bili obuhvaćeni bolesnici sa znacima i simptomima pandemijskog gripa A (H1N1), hospitalizovani u Klinici za infektivne bolesti u Novom Sadu. Studijom je bilo obuhvaćeno 293 bolesnika hospitalizovanih u periodu od oktobra 2009. do februara 2010. godine. Analizirani su osnovni demografski podaci, osnovne bolesti, znaci i simptomi gripa, trajanje simptoma do hospitalizacije, laboratorijske analize, radiografski nalaz, terapija i ishod bolesti (preživeli, umrli). Definisanje faktora rizika od težeg oblika bolesti vršeno je upoređivanjem karakteristika ICU bolesnika sa karakteristikama bolesnika koji nisu zahtevali hospitalizaciju u ICU. Rezultati. Prosečna starost bolesnika bila je 32,72 godine. Osnovne bolesti imalo je 114 (38,9%) bolesnika. Astma i hronična opstruktivna bolest pluća registrovana je kod 44 (15,01%) bolesnika, hronična kardiovaskularna oboljenja imalo je 28 (9,56%), šećernu bolest 16 (5,46%), malignitet 15 (4,44%) bolesnika, a 11 (3,75%) bolesnika bile su trudnice. Povišena temperatura registrovana je kod 282 (96,24%), bolovi u mišićima kod 119 (40,61%), glavobolja kod 48 (16,38%), kašalj kod 240 (81,91%), gušobolja kod 25 (8,53%), kijavica kod 17 (5,8%) i dispnea kod 110 (37,54%) bolesnika. Radiološki verifikovanu pneumoniju imalo je 192 (65,53%) bolesnika. Antivirusna terapija kod 154 (56,61%) bolesnika primenjena je u prvih 48 časova bolesti. Sa klinike je otpušteno 280 (96,24%) bolesnika, a 13 (4,44%) bolesnika je premešteno u ICU. Smrtni ishod zabeležen je kod 2/13 (15,3%) bolesnika lečenih u ICU, dok je 11/13 (84,7%) preživelo. Prosečno vreme od pojave simptoma do primene antivirusne terapije iznosilo je 7,1 dana za bolesnike lečene u ICU, a 3,2 dana za bolesnike koji nisu bili hospitalizovani u ICU (p < 0,05). Hipoksemija sa saturacijom kiseonika SaO2 ≤ 92% registrovana je kod 10/13 (76,92%) bolesnika lečenih u ICU, i kod 28/280 (10%) koji nisu premešteni u ICU (p < 0,01). Vrednosti C-reaktivnog proteina (CRP) u serumu > 200 mg/L zabeležena su kod 9/13 (69,23%) bolesnika u ICU i kod 85/280 (30,35%) bolesnika bez transfera u ICU (p < 0,05). Zaključak. Novi grip se ispoljava uglavnom kao blago respiratorno oboljenje. Rana primena antivirusne terapije može sprečiti razvoj težih formi oboljenja. Posebnu pažnju treba obratiti na bolesnike sa hipoksemijom i porastom vrednosti CRP u serumu.
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O članku

jezik rada: engleski
vrsta rada: izvorni naučni članak
DOI: 10.2298/VSP1302155C
objavljen u SCIndeksu: 05.02.2013.
metod recenzije: dvostruko anoniman