病毒性肺炎患者随访1年情况分析

摘要：目的：将随访结果与急性期存在的临床特点对比，探讨普通型病毒性肺炎患者长期存在的临床特征。方法：回顾南宁市第四人民医院 2020 年 1 月至 2021 年 11 月治愈出院的 54 例普通型病毒性肺炎患者，收集其入院至出院后 1 年的临床资料并对比分析。结果：所有患者预后良好，个别患者咳嗽咳痰症状可持续 1 月；大部分急性期出现肝肾功能损害患者，出院 1 月复查肝肾功能指标仍高，随访半年后肌酐仍未降至正常水平；基本所有进行病毒抗体检测患者均长期存在阳性的特异性抗体，且其抗体可在转阴后再次出现阳性。大部分患者肺部病灶明显吸收，个别吸收缓慢的病灶可存在半年甚至 1 年。结论：病毒性肺炎患者临床治愈出院后，大部分患者的临床症状可较快恢复至发病前状态，但可能长期存在肝肾功能异常、特异性抗体 IgG 阳性和缓慢吸收的肺部炎症病灶。

关键词：病毒性肺炎；长期症状；肝脏损伤；急性肾损伤；特异性抗体

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Analysis of One-Year Follow-Up Outcomes in Patients With Viral Pneumonia: A Case Report of Severe Illness

Abstract: Objectives: To compare follow-up findings with clinical manifestations during the acute phase and investigate long-term clinical features in patients with common-type viral pneumonia. Methods: A total of 54 patients diagnosed with common-type viral pneumonia who were cured and discharged from the Fourth People’s Hospital of Nanning between January 2020 and November 2021 were enrolled retrospectively. Clinical data from admission to one year after discharge were collected and compared. Results: All patients achieved favourable prognosis; only a small number presented with cough and expectoration lasting for one month. In most patients with acute hepatic and renal impairment, liver and kidney function indices remained elevated at the 1-month follow-up after discharge, and serum creatinine failed to return to normal until half a year later. Specific antiviral antibodies persisted positive long-term in nearly all patients receiving antibody testing, with recurrent seropositivity after transient seroconversion to negative. Pulmonary lesions were markedly absorbed in most cases, whereas a few lesions resolved slowly and persisted for half a year or even one year. Conclusions: After clinical cure and hospital discharge, most patients with viral pneumonia recover rapidly from clinical symptoms to pre-illness status, but long-standing abnormalities of liver and renal function, persistent positive specific IgG antibodies and slowly resolving pulmonary inflammatory lesions may remain.

Keywords: Viral pneumonia; Long-term sequelae; Liver injury; Acute kidney injury; Specific antibodies

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