聚集性人B组7型腺病毒性肺炎218例临床特征分析

Clinical characteristics of 218 adult human patients with adenovirus type 7 pneumonia

目的通过对成人腺病毒B组7型腺病毒性肺炎住院患者的临床及胸部CT资料进行分析,总结规律,探讨腺病毒肺炎的早期诊断和治疗。方法收集2015年2月至2015年3月收治的218例成人腺病毒B组7型肺炎住院患者病例,并采集咽拭子实时定量PCR法检测病毒核酸查找腺病毒阳性感染患者,同时记录症状、体征、实验室检查等临床资料,观察肺CT影像学表现。结果疫情主要集中在2月至3月份。患者均为年轻男性,平均年龄为(19±1.5)岁。体温正常阳性者主要表现咳嗽、咽痛、腹痛、腹泻等。胸部CT显示,肺部有节段性肺实变,部分有间质性改变,晚期可出现闭塞性细支气管炎、支气管壁增厚、支气管扩张,胸膜炎。实验室检查显示,部分患者的白细胞、中性粒细胞百分率偏高、单核细胞百分率偏高,淋巴细胞百分率降低。平均病程为(4.91±4.20)d。所有患者均治愈出院,无死亡。结论成人腺病毒B组7型阳性肺炎患者临床表现可有病毒性上呼吸道感染、支气管炎症状,及急性肠胃炎症状。肺CT显示单发肺部实变和磨玻璃样病变较多;重者可出现多叶实变及支气管扩张等。及时CT检查确诊和治疗可改善预后,减少并发症。

Objective To investigate the chest CT characteristics of 218 patients infected with human adenovirus type 7. Methods A total of 218 patients of human adenovirus pneumonia were admitted to hospital from February 2015 to March 2015 were observed. The clinical features of the disease include symptoms,signs,images and laboratory tests. To confirm infection,real time polymerase chain reaction was performed using patients＇ swabs to detect adenovirus. The chest CT were examined for every patient. Results Most covert infected patients happened in February to March. Total patients were male. Mean age was 19 ± 1. 5 years old,ranging from 17-25 years old. Contact link such as obvious dormitory and mess hall aggregation were seen between patients. The most commonly symptoms were cough,pain of tonsil,abdominal pain,diarrhea. The most common signs were pharyngeal congestion,enlargement of tonsils,and lymphatic follicular hyperplasia.The chest CT scan shows that single lobe or multi-lobes exudative lesions, some have ground glass opacification,even brochiectasis,bronchiolitis,pleural effusion. Laboratory tests showed that the number of white blood cells,neutrophils and monocytes in the peripheral blood in most patients was elevated. Some occult infected transformed into upper respiratory infection or acute enteritis. Conclusion the clinical characteristics of human adenoviral pneumonia includes symptoms of fever,cough,pain of tonsil,expectation,abdominal pain and diarrhea. The chest CT shows single lobe or muilti-lobe exudative lesions,brochieastasis.Or WBC,Neutrophil and monocytes may be elevated. Earlier diagnosis of pneumonia can.