重度腺病毒肺炎儿童临床症状、血生化指标及影像学表现分析  

Analysis of Clinical Symptoms, Blood Biochemical Indexes and Imaging Findings in Children with Severe Adenovirus Pneumonia

作　　者：张伟东[1] 寇丽[2] 王幸丽 杨红[1] 张义堂[1] ZHANG Wei-dong;KOU Li;WANG Xing-li(PICU,The Affiliated Hospital of Zhengzhou University,The Central Hospital of Nanyang City,Nanyang 473000,Henan Province,China)

机构地区：[1]郑州大学附属医院/南阳市中心医院PICU,河南南阳473000 [2]湖北省襄阳市中心医院普外二科,湖北襄阳441021

出　　处：《中国CT和MRI杂志》2020年第4期50-53,共4页Chinese Journal of CT and MRI

摘　　要：目的分析重度腺病毒肺炎儿童临床症状、血生化指标及影像学表现。方法回顾性分析我院2012年7月-2018年3月收治的100例重症腺病毒肺炎患儿的入院记录、病例、影像学表现等资料,分析其特征。结果患儿入院时均伴不同程度发热、呼吸系统症状,其中39℃~41℃占比80.00%,呼吸系统症状中以咳嗽(96.00%)、呼吸气促(86.00%)为主;肺部可闻及湿罗音(89.00%)、哮鸣音(67.00%),部分兼并发生;并发症以呼吸系统(100.00%)、循环系统(64.00%)为主;C反应蛋白(CRP)及肌酸激酶混合同工酶(CK-MB)升高比重均高达60.00%;其次为白细胞计数(WBC)升高(52.00%);CT影像均提示肺实变,其中双肺受累80.00%,76.00%受累肺叶数≥3个,多呈向心性分布,以团簇状影最常见,实变部位均匀强化占比48.00%;另有28.00%检出淋巴结肿大,但大多强化均匀;71.00%患儿伴小气道改变,其中充气不均匀占比84.51%、其次为支气管壁增厚(61.97%)、支气管扩张(40.85%)、马赛克征(33.80%)。结论重度腺病毒肺炎儿童易累及肺外器官组织,并发症较多,应重视血生化指标检测,警惕CT小气道改变征像。Objective To analyze the clinical symptoms, blood biochemical parameters and imaging findings in children with severe adenovirus pneumonia. Methods The data such as admission records, cases and imaging findings of 100 children with severe adenovirus pneumonia who were admitted to the hospital from July 2012 to March 2018 were analyzed retrospectively. Results All children had different degrees of fever or respiratory symptoms at admission and 39℃~41℃ accounted for 80.00%. The main respiratory symptoms were cough(96.00%) and tachypnea(86.00%). There were wet rales(89.00%) or wheezing(67.00%) in lungs, and there were both in partial lungs. Main sites of complications included respiratory system(100.00%) and circulatory system(64.00%). The ratio of increased C-reactive protein(CRP) and creatine kinaseisoenzyme(CK-MB) was 60.00%, followed by increased white blood cell count(WBC)(52.00%). CT images showed lung consolidation, including 80.00% of double-lung involvement and 76.00% of affected pulmonary lobes ≥3, mostly showing concentric distribution. Cluster-like shadow was the most common. Homogenous enhancement of consolidation accounted for 48.00%. 28.00% of the patients had lymphadenopathy, and the enhancement was homogenous. 71.00% of children had small airway change, and uneven inflation accounted for 84.51%, followed by bronchial wall thickening(61.97%), bronchiectasis(40.85%) and mosaic sign(33.80%). Conclusion Children with severe adenovirus pneumonia are more likely to have involvement of extrapulmonary organs and tissues, with many complications. It is necessary to pay attention to the detection of blood biochemical indicators and be alert to CT small airway changes.

关 键 词：重度腺病毒肺炎儿童 临床症状 血生化指标 影像学表现 

分 类 号：R725.6[医药卫生—儿科] R445.3[医药卫生—临床医学]