武警新兵腺病毒肺炎在不同海拔地区的临床特征

Clinical characteristics of adenovirus pneumonia in the recruits of PAP at different altitudes

【目的】总结描述腺病毒在不同海拔地区的致病特点。【方法】本研究搜集武警新兵在不同海拔地区患腺病毒肺炎后的临床资料,按照海拔不同分为平原组(n=221)和高原组(n=109),从两组患者的一般临床情况、症状和体征、实验室检查、影像学特征、临床结局等方面进行总结和回顾性分析研究。【结果】两组患者腺病毒分型均为B55型,平原组患者平均病程长于高原组(P=0.047)。两组患者的主要症状包括发热(91.51%),平均热程为(4.23±2.66)d,平原组患者平均体温高于高原组[(39.40±0.83)℃vs(38.67±0.74)℃,(P<0.001)],平原组超过40℃体温者多于高原组(24.43%vs 1.83%,P<0.001);咳嗽(92.42%)、咳痰(81.81%)、咽痛(45.76%)为主的呼吸道症状在两组常见,平原组多合并全身症状(64.71%vs 24.77%,P<0.001)。最常见的体征为咽充血(79.70%)和扁桃体不同程度的肿大(31.82%),两组无统计学差异;肺部闻及湿啰音在平原组常见(36.65%vs 10.09%,P<0.001),高原组呼吸音减低常见(4.52%vs 16.51%,P<0.001)。平原组双肺受累比例亦高于高原组(47.96%vs 33.03%,P=0.01),因病情进展转入ICU治疗的患者比例也高于高原组(7.69%vs 0.92%,P=0.011)。两组患者临床结局良好,差异无统计学差异。【结论】武警新兵在不同海拔地区患腺病毒肺炎后呈现出相似的临床表现,在症状与体征、实验室检查结果以及肺炎发生部位上有不同。

【Objective】To summarize and describe the pathogenic characteristics of adenovirus at different altitudes.【Methods】The clinical data of the recruits of PAP with adenovirus pneumonia at different altitudes were collected,and they were divided into plain group(n=221)and plateau group(n=109)according to the altitude.The general clinical conditions,symptoms and signs,laboratory outcomes,imaging features and clinical outcomes of the two groups were summarized and retrospectively analyzed.【Results】The virus’types of the two groups were both B55.The average course of disease in the plain group was longer than that in the plateau group(P=0.047).The main symptoms of adenovirus pneumonia in the two groups were fever(91.51%),and the average duration of fever was(4.23±2.66)d,and the average temperature in the plain group was higher than that in the plateau group[(39.40±0.83)℃vs.(38.67±0.74)℃,P<0.001].Patients with temperature over 40℃in the plain group were more than those in the plateau group(24.43%vs.1.83%,P<0.001).The main respiratory symptoms were cough(92.42%),expectoration(81.81%),and pharyngeal pain(45.76%),while the patients in the plain group were more complicated with systemic symptoms(64.71%vs.24.77%,P<0.001).The most common signs were pharyngeal hyperemia(79.70%)and tonsil swelling(31.82%)with no statistical difference between the two groups.Rales were common in the plain group(36.65%vs.10.09%,P<0.001),and decreased breath sounds were common in the plateau group(4.52%vs.16.51%,P<0.001).The proportion of double lung involvement in the plain group was higher than that in the plateau group(47.96%vs.33.03%,P=0.01),and the proportion of patients transferred to ICU due to the progress of disease(7.69%vs.0.92%,P=0.011)was also higher than that in the plateau group.The outcomes of the two groups were good with no significant difference.【Conclusion】The clinical manifestations of adenovirus pneumonia in the recruits of PAP at different altitudes are similar.There are differences insymptoms and signs,laboratory outcomes and the site of pneumonia.