H7N9型禽流感临床表现和影像学特征  

Clinical and imaging features of pneumonia caused by H7N9 subtype avian influenza virus

作　　者：毛新峰[1,2] 胡春洪[1] 祝跃明[2] 赵育英[2] 丁琴妹 熊敏荣 

机构地区：[1]苏州大学附属第一医院影像中心,江苏苏州215006 [2]湖州市中心医院放射科,浙江湖州313000 [3]湖州市南浔区人民医院放射科,浙江湖州313009

出　　处：《中国医学影像技术》2014年第1期74-77,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨H7N9型禽流感病毒性肺炎的临床表现和影像学特征。方法回顾分析8例经逆转录-聚合酶链反应(RT-PCR)临床确诊为H7N9禽流感患者的临床及影像学资料。结果患者均以发热、咳嗽、咳痰为首发症状,超敏C反应蛋白明显升高。8例中,5例表现为肺实变影,间质性改变1例,磨玻璃改变2例。两肺多叶、多段受累,可勾勒出肺段轮廓,未见病变跨越肺叶征象。病变具有游走性,进展期实变影出现或增多;病灶吸收缓慢,可出现肺纤维化。8例均见不同程度胸膜反应,3例可见胸腔积液;未见肺门及纵隔淋巴结肿大。结论 H7N9禽流感病毒性肺炎的临床及影像学表现有一定特点,但无明显特异性;影像学检查有助于指导临床及时进行治疗。Objective To explore the clinical and imaging characteristics of pneumonia caused by H7N9 subtype of human avian influenza virus. Methods Clinical materials and imaging manifestations of 8 patients infected by influenza H7N9 con- firmed by laboratory finding with reverse transcription-polymerase chain reaction （RT-PCR） were retrospectively analyzed. Results The initial symptoms included high fever, cough and expectoration, with hypersensitive C-reactive protein in- creased significantly. Among 8 cases, 5 showed consolidation appearances, 1 demonstrated interstitial changes, 2 had ground-glass appearances. Multi-lobar or multi-segmental invasion of bilateral lungs were found. The lesions could draw outline of lung segment, but did not cross interlobar fissure. The lesions had characteristic roving around. The consolida- tion appeared and increased in the progressive phase. The absorption of lesions focused with prolongation time, and the pulmonary fibrosis could be found. All cases displayed pleura reaction, 3 had pleural effusion. Lymph node enlargement in hilum of lung and mediastinal was not observed. Conclusion H7N9 avian influenza virus has certain characteristics, but prompt and effective treatment. Clinical and imaging appearances of pneumonia caused by not obvious specificity. Imaging examination contributes to

关 键 词：肺炎 病毒性 H7N9人禽流感 体层摄影术 X线计算机 

分 类 号：R563.1[医药卫生—呼吸系统] R814.42[医药卫生—内科学]