腺病毒7型感染306例流行病学和临床特点分析

Analysis on epidemiological and clinical features in 306 patients with infection of adenovirus type 7

目的探讨2013年驻鄂某部队腺病毒7型所致的呼吸道感染的流行病学和临床特点。方法2013年1—3月，我院收治驻鄂某部队呼吸道感染患者306例，分析其流行病学特点和临床特点。结果306例患者均来自同一部队，疫情波及整个营区，2013年1月中下旬形成发病高峰。患者中新兵占98％，发热、咳嗽、咽痛为主要表现，少部分患者出现腹泻、眼部不适、胸闷，部分患者扁桃体或咽后壁可见灰白色附着物。辅助检查：病毒学检测为腺病毒7型，近半数患者病初白细胞计数偏高，随后下降低于正常，可有血沉偏快，C反应蛋白升高，心肌酶谱升高、肝功能损害，其中肺部CT提示腺病毒肺炎52例。在301医院和302医院专家组指导下，经综合治疗均治愈出院。病程1—20（7．5±6．2）d。结论发生在驻鄂某部队的急性呼吸道感染暴发疫情病原为腺病毒7型，以呼吸道传播为主。腺病毒7型感染患者临床表现多样化，但以急性上呼吸道感染为主，特征性表现是扁桃体灰白色附着物，部分出现其他脏器损害，腺病毒肺炎是影响病程的主要因素。

Objective To discuss the epidemiological and clinical features of respiratory infection caused by adenovirus （ADV） type 7 in a military force in Hubei province in 2013. Methods A total of 306 patients with respiratory infections admitted to our hospital during Jan. and Feb. 2013 were analyzed on the aspects of the epidemiologieal and clinical features. Results All the 306 patients were from the same military unit. The epidemic disease spread throughout the whole camp, with an outbreak peak in the mid and late Jan. 2013. Among the patients, recruits accounted for 98%. The symptoms consisted of fever, cough and sore throat in most patients, and diarrhea, eye discomfort and chest tightness in a few. There were gray attachments on the walls of pharyngeal tonsils in some patients. Laboratory test findings included positive ADV type 7, change in white blood cell count （ increased at beginning and decreased to lower than normal thereafter） , and increases in erythrocyte sedimentation rate （ESR） , C-reactive protein and myocardial and hepatic enzymes. As for CT, 52 patients showed the findings in compliance with adenoviral pneumonia. Under the guidance of the experts from No. 301 Hospital and No. 302 Hospital, the patients were treated and healed up, with a disease course of 1 - 20 （7.5± 6.2） days. Conclusion ADV type 7 acts as the pathogen that spread via respiratory tract and led to the outbreak of acute respiratory infection among the servicemen of a military force in Hubei province in 2013. The patients with adenoviral infection possess various manifestations, mainly as acute upper respiratory tract infection. Adenoviral pneumonia is deemed as the main factor that impacts on the developing course.