儿童腺病毒感染后闭塞性细支气管炎的临床分析  

Clinical analysis of adenovirus post-infectious bronchiolitis obliterans in children

作　　者：刁嘉玲 魏梦月 王瑞珠 陈蒙[1] 赵德育[1] DIAO Jia-ling;WEI Meng-yue;WANG Rui-zhu;CHEN Meng;ZHAO De-yu(Department of Respiration,Children‘s Hospital of Nanjing Medical University,Nanjing 210008,Jiangsu,China;Department of Imaging,Children’s Hospital of Nanjing Medical University,Nanjing 210008,Jiangsu,China)

机构地区：[1]南京医科大学附属儿童医院呼吸科,南京210008 [2]南京医科大学附属儿童医院影像科,南京210008

出　　处：《医学研究生学报》2022年第2期165-169,共5页Journal of Medical Postgraduates

基　　金：南京市医学科技发展项目(YKK16180)。

摘　　要：目的目前感染后闭塞性细支气管炎(PIBO)治疗后临床转归情况尚不明确。文中旨在研究儿童腺病毒PIBO的临床转归情况。方法收集2019年2月至2019年8月因罹患腺病毒肺炎在南京医科大学附属儿童医院呼吸科和感染科住院并在呼吸科的随访中确诊为PIBO的26例患儿作为研究对象。分别记录其确诊时、确诊后6个月、12个月、18个月和24个月时临床表现、胸部高分辨率CT(HRCT)、肺功能和生长发育的变化。结果随访6个月、12个月、18个月和24个月时,分别有46.2%,76.9%,76.9%和80.8%的患儿临床症状改善,随着随访时间增长,临床症状改善率越来越高(P<0.01),运动不耐受发生率越来越低(P<0.01)。随访至24个月,所有23例复查HRCT的患儿均仍然有马赛克灌注征,完成肺功能检查的20名患儿中,有19例患儿仍然表现出阻塞性通气功能障碍。结论大部分PIBO患儿的临床症状可逐渐、明显地改善,但是影像学的改变和肺功能的的损害可持续存在。Objective At present, the clinical outcome of PIBO affter treatment is still unclear. This article aimed to study the clinical outcomes of adenovirus post-infectious bronchiolitis obliterans(PIBO) in children. Methods 26 children with post-infectious bronchiolitis obliterans(PIBO) caused by adenovirus pneumonia who were admitted to the Children′s Hospital of Nanjing Medical University from February 2019 to August 2019 were collected. The changes of their clinical manifestations, the chest HRCT, pulmonary function and growth were recorded at the time of diagnosis, 6 th-month, 12 th-month, 18 th-month, and 24 th-month after diagnosis. Results At 6 th-month, 12 th-month, 18 th-month, and 24 th-month of follow-up, there were 46.2%, 76.9%, 76.9%, and 80.8% of the children had improved clinical symptoms. With the increase of follow-up time, the improvement rate of clinical symptoms was higher(P<0.01), and the incidence of exercise intolerance was lower(P<0.01). At 24 th-month follow-up, all 23 children who underwent HRCT still had mosaic attenuation. Among 20 children who underwent pulmonary function tests, 19 children still showed obstructive ventilatory defect. Conclusion The clinical symptoms of most children with PIBO could improve gradually and significantly, but the changes on HRCT and the damage of lung function could persist.

关 键 词：腺病毒感染 感染后闭塞性细支气管炎 随访 儿童 

分 类 号：R562.21[医药卫生—呼吸系统]