目的探讨甲型H1N1流感重症病例的临床特征。方法回顾分析2例住院甲型H1N1流感危重症的临床表现、实验室检查结果。结果 2例患者早期均有轻度的流感样症状,发热,咳嗽、咳痰,第3～4天病情加重,气促明显,原有基础疾病症状显著。后期出现多脏器功能不全,以呼吸功能不全出现较早,且严重。实验室检查白细胞计数、中性粒细胞比率增高,淋巴细胞比率减低,肾功能、凝血指标异常。X线胸片两肺均有广泛受累。结论有基础疾病的甲型H1N1流感患者,发病后病情进展较快,易发展为危重症病例,病死率高。对易发展为重症的高危人群,早预防,早识别,早治疗,是降低其死亡率的关键。 Objective To investigate the clinical features of severe cases of Influenza A (H1N1). Methods The clinical manifestations and laboratory findings of 2 critically ill patients with influenza A (H1N1) in hospital were retrospectively analyzed. Results Both of the two patients had mild flu-like symptoms in the early stage. Fever, cough and sputum were observed in the two cases. The condition was aggravated on the 3rd to 4th days with obvious gas shortness. The symptoms of the original basic diseases were significant. Late multiple organ dysfunction, respiratory insufficiency appeared earlier, and serious. Laboratory tests leukocyte count, increased neutrophil ratio, lymphocyte ratio decreased, renal function, coagulation abnormalities. X-ray chest has extensive involvement of both lungs. Conclusions Patients with A / H1N1 flu who have underlying diseases have progressed rapidly after the onset of the disease and are apt to develop into critically ill cases with high case fatality rates. Easy to develop at high risk for critically ill people, early prevention, early identification, early treatment, is to reduce the mortality of the key.