EB病毒感染所致肺部感染患者的胸部高分辨CT特征分析  

Analysis of chest high resolution CT features in patients with pulmonary infection caused by Epstein-Barr virus infection

作　　者：何馨[1] 姚志刚[1] 符玉环[2] 聂姗[1] 吴艳军[1] 王维[1] 吴波[1] 王浩彦[1] 徐波[1] He Xin;Yao Zhigang;Fu Yuhuan;Nie Shan;Wu Yanjun;Wang Wei;Wu Bo;Wang Haoyan;Xu Bo(Department of Respiratory Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院呼吸内科,100050 [2]首都医科大学附属北京友谊医院放射科,100050

出　　处：《北京医学》2022年第3期236-240,共5页Beijing Medical Journal

基　　金：北京市临床重点专科建设项目(2020-2022)。

摘　　要：目的总结爱泼斯坦-巴尔病毒(Epstein-Barr virus,EBV)感染所致肺部感染的胸部高分辨CT(high resolution CT,HRCT)特征,并探讨其临床诊断价值。方法回顾性分析2017年11月至2020年2月首都医科大学附属北京友谊医院收治的16例EBV感染所致肺部感染患者的临床资料,包括性别、年龄、临床诊断、症状、体征、实验室检查、EBV-DNA拷贝数、EBV抗体及胸部HRCT表现等。结果16例患者中男10例,女6例,年龄11~62岁;临床诊断包括嗜血细胞综合征12例(75.0%)、慢性活动性EBV感染1例(6.2%),EBV感染2例(12.5%)及乳腺癌术后维持化疗1例(6.2%)。患者外周血EBV-DNA均阳性,拷贝数>5.0×10;拷贝/ml,7例EBV相关抗体阳性,提示EBV急性感染或机体存在EBV复制。胸部HRCT主要表现为磨玻璃密度斑片影(87.5%)、淋巴管周围结节(81.2%)、小叶间隔不规则增厚(68.8%)、支气管血管束旁结节(56.2%)、胸膜下结节影(50.0%)、支气管血管束增粗(43.8%)和小叶内间隔增厚(37.5%),其他表现有胸腔积液(25.0%)和纵隔/肺门淋巴结肿大(6.2%)。结论EBV感染所致肺部感染主要表现为间质性肺炎,病变沿肺内淋巴管走行分布,以多种形态混合多见。胸部HRCT表现具有一定特征,可为临床诊断提供一定参考。Objective To summarize the characteristics of high resolution CT(HRCT)in chest of pulmonary infection caused by Epstein-Barr virus(EBV)infection,and to explore its clinical diagnostic value.Methods The clinical data of 16 patients with pulmonary infection caused by EBV infection admitted to Beijing Friendship Hospital,Capital Medical University from November 2017 to February 2020 were retrospectively analyzed,including gender,age,clinical diagnosis,symptoms,signs,laboratory examination,EBV-DNA copy number,EBV antibody and chest HRCT manifestations.Results A total of 16 patients were included,there were 10 males and six females,aged from 11-62 years.Clinical diagnosis included 12 cases(75.0%)of hemophagocytic syndrome,one cases(6.2%)of chronic active EBV infection,two cases(12.5%)of EBV infection and one case(6.2%)of postoperative maintenance chemotherapy for breast cancer.All the patients were positive for EBV-DNA in peripheral blood with copy number>5.0×10~2 copies/ml,and seven cases were positive for EBV-related antibodies,suggesting acute EBV infection or EBV replication in the body.The main manifestations of chest HRCT were ground glass density patches(87.5%),perilymphatic nodules(81.2%),irregular thickening of interlobular septa(68.8%),parabronchovascular nodules(56.2%),subpleural nodules(50.0%),bronchovascular bundles thickening(43.8%)and interlobular septa thickening(37.5%),and other manifestations were pleural effusion(25.0%)and mediastinal/hilar lymphadenopathy(6.2%).Conclusions The pulmonary infection caused by EBV infection is mainly manifested as interstitial pneumonia.The lesions are distributed along the lymphatic vessels in the lung and are more common in mixed forms.Chest HRCT findings have certain characteristics,which can provide a certain reference for clinical diagnosis.

关 键 词：爱泼斯坦-巴尔病毒 肺部感染 间质性肺炎 高分辨CT 

分 类 号：R752.1[医药卫生—皮肤病学与性病学] R563.1[医药卫生—临床医学] R816.4