具有特应性体质的腺病毒肺炎患儿临床特征及影像学改变  

Clinical characteristics and imagological changes of atopic children with ADV pneumonia

作　　者：李淼[1] 韩晓华[1] 刘立云[1] 姚慧生[1] 伊丽丽[1] Li Miao;Han Xiaohua;Liu Liyun;Yao Huisheng;Yi Lili(Department of Respiratory Pediatrics,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院小儿呼吸内科,沈阳110004

出　　处：《国际儿科学杂志》2020年第11期806-810,共5页International Journal of Pediatrics

摘　　要：目的探讨具有特应性体质的腺病毒肺炎患儿临床特征及影像学改变。方法选取中国医科大学附属盛京医院小儿呼吸科2018年6月至2019年12月收治的腺病毒肺炎患儿120例,根据有无特应性体质及肺炎严重程度分为有特应性体质组42例(轻型肺炎30例,重症肺炎12例)及无特应性体质组78例(轻型肺炎50例,重症肺炎28例)。住院期间按照腺病毒肺炎诊治指南进行治疗,出院1个月后进行随访,并对患儿住院期间化验检查、临床表现、临床特征、入院、出院时及随访时肺部影像学改变进行统计分析。结果在轻型肺炎患儿中,具有特应性体质的患儿与无特应性体质患儿相比,严重咳嗽的比例、出现喘息比例差异有统计学意义(分别为P=0.041,P=0.004);两组间入院时及出院后1个月肺CT提示小气道改变的患者比例差异无统计学意义(P>0.05);其中有特应性体质患儿住院期间出现喘息的风险是无特应性体质患儿的2.32倍;出现严重咳嗽的风险是无特应性体质患儿的1.72倍。在重症肺炎患儿中,有特应性体质患儿与无特应性体质患儿相比,入院时及出院后喘息比例差异有统计学意义(分别为P=0.002,P=0.034)。两组间入院时及出院时出现小气道改变的比例差异显著(分别为P=0.001,P=0.009);其中有特应性体质患儿住院期间出现喘息的风险是无特应性体质重症肺炎患儿的1.94倍;出院后出现喘息风险是无特应性体质患儿的1.98倍;有特应性体质的重症肺炎患儿入院时出现小气道改变风险为无特应性体质肺炎患儿的1.25倍;出院后一个月仍有小气道改变的风险为无特应性体质患儿的2.31倍。结论患有特应性体质的腺病毒轻型肺炎患儿住院期间咳嗽症状重,易出现喘息;重症腺病毒肺炎的特应性体质患儿肺部影像学易出现小气道改变,肺部影像学恢复时间长,需定期随访,应引起临床医生重视。Objective To investigate the clinical characteristics and imagological changes of atopic children with ADV pneumonia.Methods One hundred and twenty cases of children with ADV pneumonia selected from Shengjing Hospital of China Medical University Pediatric Respiratory Department from June 2018 to December 2019.According to whether had atopy and severity of pneumonia,the children were divided into atopic group 42 cases(mild pneumonia 30 cases,severe pneumonia 12 cases)and non-atopic group 78 cases(mild pneumonia 50 cases,severe pneumonia 28 cases).The children were treated according to the guidelines of ADV pneumonia diagnosis and treatment.Laboratory examination,clinical manifestations,clinical features during hospitalization,pulmonary imaging changes at admission,at discharge and follow-up 1 month after discharge were statistically analyzed.Results There were statistically significant differences in the proportion of severe cough and wheezing between the atopic children and non-atopic children with mild pneumonia(P=0.041,P=0.004,respectively).There was no statistically significant difference between the two groups in the proportion of children with small airway changes indicated by lung CT at admission and 1 month after discharge(P>0.05).The risk of wheezing during hospitalization of atopic children was 2.32 times as much as that of non-atopic children with mild pneumonia.The risk of developing severe cough was 1.72 times as much as that of non-atopic children with mild pneumonia.There were statistically significant differences in the proportion of wheezing after admission and after discharge between the atopic children and non-atopic children with severe pneumonia(P=0.002,P=0.034,respectively).There were significant differences in the proportion of small airway changes at admission and at discharge between the two groups(P=0.001,P=0.009,respectively).The risk of wheezing during hospitalization of atopic children was 1.94 times as much as that of nonatopic children with severe pneumonia.The risk of wheezing after

关 键 词：儿童 特应性体质 腺病毒肺炎 临床特征 影像学改变 

分 类 号：R725.6[医药卫生—儿科]