重症登革热合并肺部改变患者临床特征分析

Clinical Characteristic of Severe Dengue Patients with Lung Lesion

目的回顾分析重症登革热（SD）合并肺部改变患者的临床和影像学特征,引起临床医生重视。方法回顾性分析广州市第八人民医院2014~2015年收治的120例重症登革热患者,分成有和无肺部改变两组,对其临床、实验室及影像学资料做对比分析。结果 120例SD患者中,48例合并肺部改变,占40.0%;其中60岁以上老年患者占83.3%,伴有糖尿病、高血压病、心脏病、慢性肺病基础的更易合并肺部改变。除均有发热外,合并肺部改变者主要表现为咳嗽、气促。两组在白细胞及降钙素原（PCT）变化有统计学差异（P〈0.05）。肺部改变胸部影像学检查主要表现为肺间质病变（n=22）、胸腔积液（n=24）、胸膜增厚（n=4）。结论有高血压病、糖尿病、心脏病及肺病的SD老年患者更容易出现肺部改变,监测白细胞及PCT的动态变化可指导抗生素治疗,尽早行胸部CT有助于早期诊断,避免漏诊。

Objective The clinical and imaging features of patients suffering from Severe Dengue（ SD） with lung lesion were analyzed in order to attract the attention of clinical doctors. Methods Two groups separated by lung lesion including 120 patients were compared in clinical,laboratorial and imaging materials. Results In all the 120 SD patients,48 had lung lesion,accounting 40. 0%. 83. 3% of patients were older than 60 who had Diabetes,Hypertension. Lung diseases were more easier to suffer with lung lesion. Except fever,the main clinical symptoms of patients with lung lesion were cough and panting. There were statistical differences in WBC and PCT between the groups. The main representations of imaging examination in lung were interstitial abnormalities（ n = 22）,pleural effusion（ n = 24） and pleural thickening（ n = 4）. Conclusion The old SD patients who had Hypertension,Diabetes,Heart diseases and Lung diseases were more easier to suffer with lung lesion. Detecting the dynamic changes of WBC and PCT can conduct the use of antibiotics. It was good to make breast CT as early as possible for early diagnosis.