肠道病毒71型感染患儿胸X线片表现

Chest X-ray findings in children with enterovirus 71 infection

目的研究肠道病毒71型感染患儿的胸部X线影像特点。方法选取2010年4月至2011年7月肠道病毒71型感染患儿120例,按病情分成轻型组(31例)、重型组(43例)、危重型组(46例),对患儿发病至首次拍片时间以及首次胸部X线片影像进行比较。结果各组发病至首次胸部X线片检查时间分别为:轻型组26～48 h(中位时间37 h);重型组10～36 h(中位时间23 h);危重型组2～36 h(中位时间19 h)。最早发现胸部X线片异常的时间轻型组约为发病后30 h;重型组约为发病后23 h;危重型组约为发病后2 h;3组胸部X线片最早出现异常的时间差异有统计学意义(P<0.01)。首次影像异常率:轻型组5.8%,重型组81.3%,危重型组100%,危重型组首次X线片的异常比例明显高于其他两组(P<0.01)。在胸部X线片的表现上,轻型组最常见的征象为肺纹理增粗、模糊;重型组常见表现为渗出、实变影;危重型则表现为肺水肿征像。危重型组病灶分布广,累及多个肺叶。结论肠道病毒71型感染患儿首次胸片检查时间、胸片出现异常的时间、异常率、胸部X线片表现严重度与临床病情严重程度相关。

Objective To study the characteristics of the chest X-ray images in children infected with enterovirus 71. Methods A total of 120 children with enterovirus 71 infection between April,2010 and July,2011 were classified into three groups according to the disease condition： mild（31 cases）,severe（43 cases） and life-threatening（46 cases）.The period from the onset of clinical symptoms to the first chest X-ray imaging examination and the results of the first chest X-ray findings were compared among the three groups. Results The period from the onset of clinical symptoms to the first chest X-ray imaging examination in the mild,severe and life-threatening groups was 26-48 hrs（median 37 hrs）,10-36 h（median 23 hrs）and 2-36 hrs（median 19 hrs） respectively. Chest X-ray abnormalities were initially observed at 30 hrs after the onset of clinical symptoms in the mild group,at 23 hrs in the severe group and at 2 hrs in the life-threatening group（P〈0.01）.The mild group presented an initial imaging abnormality rate of 5.8%,the severe group 81.3% and the life-threatening group 100%.The life-threatening group showed a significantly higher initial X-ray abnormality rate than the other two groups（P〈0.01）.In terms of chest X-ray performance,the mild group usually presented lung marking thickening or vagueness.Most children in the severe group presented lung effusion and consolidation.Signs of pulmonary edema were found in the life-threatening group,and lesions in the life-threatening group were characterized by wide distribution and many lung lobe involvements. Conclusions The interval between the onset of clinical symptoms and the initial chest X-ray examination,the period of time of,and the onset of clinical symptoms,at which chest X-ray abnormalities,the abnormality rate and the severity of chest X-ray findings may be paralleled to the clinical situation in children with enterovirus 71 infection.