甲型流感病毒、鼻病毒、冠状病毒引起的成人重症社区获得性肺炎的临床特点比较

Comparison of clinical features of severe community-acquired pneumonia in adults caused by influenza A virus,rhinovirus and coronavirus

目的分析比较甲型流感病毒、鼻病毒、冠状病毒成人重症社区获得性肺炎的临床特点。方法回顾性分析哈尔滨医科大学附属第二医院呼吸科2015年10月~2018年4月住院治疗的甲型流感病毒、鼻病毒、冠状病毒成人重症社区获得性肺炎患者共93例的临床资料,其中甲型流感病毒组42例、鼻病毒组25例、冠状病毒组26例,对3组患者的年龄、吸烟情况、临床特征等进行分析比较。结果鼻病毒组合并巨细胞病毒比例高于甲型流感病毒组(P<0.05);冠状病毒组合并支原体的比例高于甲型流感病毒组(P<0.05)。甲型流感病毒组表现为磨玻璃结节影的比例高于其他两组(P<0.05)。甲型流感病毒组和冠状病毒组淋巴细胞减少的比例高于鼻病毒组(P<0.05)。结论甲型流感病毒成人重症社区获得性肺炎多有淋巴细胞减少,影像表现多为磨玻璃结节影。

Objective To analyze the clinical feature of severe community-acquired pneumonia in adults caused by influenza A virus,rhinovirus and coronavirus.Methods The clinical data of 93 adult patients with severe community-acquired pneumonia caused by influenza A virus,rhinovirus and coronavirus who were hospitalized in the Department of Respiratory Medicine in the Second Affiliated Hospital of Harbin Medical University from October 2015 to April 2018 were retrospectively analyzed.There were 42 cases in influenza A virus group,25 cases in rhinovirus group,26 cases in coronavirus group.The age,smoking status and clinical feature of the three groups of patients were analyzed and compared.Results The ratio of combined with cytomegalovirus in rhinovirus group was higher than that in influenza A virus group(P<0.05);The ratio of combined with mycoplasma in coronavirus group was higher than that in influenza A virus group(P<0.05).The proportion of groundglass nodules in influenza A virus group was higher than that in the other two groups(P<0.05).The proportion of lymphopenia in influenza A virus group and coronavirus group was higher than that in rhinovirus group(P<0.05).Conclusion Severe community-acquired pneumonia influenza A virus is more likely to have lymphopenia,and the imaging manifestations are mostly groundglass nodules.