121例成人55型腺病毒肺炎胸部CT影像分析

Chest CT characteristics of 121 adult patients with adenovirus type 55 pneumonia

目的回顾性分析121例成人55型腺病毒肺炎的胸部CT影像学表现,为该病的影像学诊断提供参考。方法总结2012年2月某单位暴发的55型腺病毒感染疫情,选择其中121例经肺部CT确诊的肺炎患者为研究对象,分析其临床表现及胸部CT特点。结果 121例体温为(39.22±0.77)℃,热程为(7.12±2.23)d,所有患者均有咳嗽、咳痰、咽痛及咽充血,其中87.60%扁桃体肿大,64.46%颈部淋巴结肿大。90例表现为肺部单叶或多叶段少许渗出性病变,22例为多叶段片状团簇状影,8例为肺部单叶条索状影,1例为支气管扩张伴感染。单肺叶病变组热程短于多肺叶病变组(P<0.05),但2组间最高体温、白细胞计数、中性粒细胞比例及CRP差异无统计学意义。结论成人55型腺病毒感染与普通上呼吸道病毒感染临床表现类似,胸部CT提示多数患者存在肺部影像学异常,肺外表现较少;多肺叶受累者并未表现出明显的重症倾向。

Objective To analyze chest CT findings of 121 adult patients with adenovirus type 55 pneumonia retrospectively, so as to provide a reference for imaging diagnosis of the disease. Methods Of the patients involved in an outbreak of adenovirus type 55 infection in a certain unit in February, 2012, 121 diagnosed with pneumonia by using lung CT scan were enrolled in the study. The clinical manifestations and chest CT features were analyzed. Results All the patients had an average temperature of 39.22±0.77 ℃ and an average duration of fever of 7.12 ± 2.23 days. All the patients presented with cough, sputum, sore throat and pharyngeal congestion, of whom 87.60% with tonsillar enlargement and 64.46% with cervical lymphadenopathy. Ninety patients showed single lobe or multi-lobe exudative lesions, 22 had multi-lobe patchy lesions, 8 single lobe cord-like shadow, and 1 bronchiectasis accompanied by infection. The duration of fever in single lobe lesion group was shorter than that in multi-lobe lesion group （P〈0.05）, but the differences in the highest temperature, white blood count, percentage of neutrophils and C-reactive protein were not significant between the 2 groups. Conclusions Adult patients with adenovirus type 55 infection have the similar clinical manifestations as the patients with ordinary upper respiratory tract infection. Chest CT scan shows lung abnormalities and fewer extra-pulmonary manifestations in the majority of the patients with adenovirus type 55 infection. Those with multi-lobe lesions do not show obvious severe tendency.