[1]阳池娇,陈进喜,白 珺.儿童7型腺病毒肺炎特点分析[J].医学信息,2020,33(02):121-124.[doi:10.3969/j.issn.1006-1959.2020.02.035]
　YANG Chi-jiao,CHEN Jin-xi,BAI Jun.Characteristics Analysis of Adenovirus Type 7 Pneumonia in Children[J].Medical Information,2020,33(02):121-124.[doi:10.3969/j.issn.1006-1959.2020.02.035]
点击复制

儿童7型腺病毒肺炎特点分析()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年02期
页码:
121-124
栏目:
调查分析
出版日期:
2020-01-15

文章信息/Info

Title:
Characteristics Analysis of Adenovirus Type 7 Pneumonia in Children
文章编号:
1006-1959（2020）02-0121-04
作者:
阳池娇; 陈进喜; 白 珺
（佛山市妇幼保健院儿科，广东 佛山 528000）
Author(s):
YANG Chi-jiao; CHEN Jin-xi; BAI Jun
(Department of Pediatrics,Foshan Maternal and Child Health Hospital,Foshan 528000,Guangdong,China)
关键词:
腺病毒7型; 肺炎; 病原感染
Keywords:
Adenovirus type 7; Pneumonia; Pathogenic infection
分类号:
R725
DOI:
10.3969/j.issn.1006-1959.2020.02.035
文献标志码:
A
摘要:
目的 分析儿童7型腺病毒肺炎的临床特征，以提高诊疗水平、改善预后。方法 回顾性分析2019年4月~7月我院收治的42例7型腺病毒肺炎患儿的临床资料，包括临床表现、实验室检查指标及影像学结果、恢复期肺功能检查、脏器功能受累情况、合并其他病原感染情况、治疗结局。结果 共42例患儿中，2岁以下29例（69.05%），均有发热，热峰＞40℃ 33例（78.57%），热程≥2周19例（45.24%）。42例患儿LDH、AST、ALT均升高，ALB降低；随着热程时间延长，LDH、AST水平升高，ALB下降，其余指标均无明显差异。影像学表现节段性实变，9例患儿初期胸片或CT表现以单侧节段性实变为主，23例患儿以双侧散发与节段性实变为主，入院1~3 d内复查胸片或CT，双侧实变迅速发展至26例（61.90%）。肺外合并症主要为血液系统损害（30.95%）为主。病原感染主要以合并肺炎支原体IgM阳性13例（30.95%）为主。呼吸支持包括鼻导管给氧9例（21.42%），无创通气24例（57.14%），机械通气9例（21.42%）。住院期间死亡3例，3例患儿因病情危重转至上级医院，其中2例死亡，1例遗留严重后遗症；其余36例（85.71%）治愈、好转出院。结论 儿童7型腺病毒肺炎热峰高，热程长，LDH、AST明显升高，影像学进展快，常伴肺内外各种损害。临床疑诊7型腺病毒肺炎时应尽快完善病原学，动态监测LDH、AST水平及影像学变化，及早治疗。
Abstract:
Objective To analyze the clinical characteristics of children with type 7 adenovirus pneumonia in order to improve the level of diagnosis and treatment and improve the prognosis.Methods The clinical data of 42 children with type 7 adenovirus pneumonia admitted in our hospital from April to July 2019 were retrospectively analyzed, including clinical manifestations and laboratory indicators and imaging results, pulmonary function tests during recovery, organ function involvement, other pathogenic infections, and treatment outcome.Results A total of 42 children, 29 cases (69.05%) under 2 years old, had fever, 33 cases (78.57%) with heat peaks> 40 °C, 19 cases(45.24%) with heat course≥2 weeks. 42 children had increased LDH, AST, and ALT, and decreased ALB; with the increase of heat course time, LDH, AST levels increased, and ALB decreased, and there was no significant difference in other indicators.Imaging showed segmental consolidation. In 9 patients, the initial chest radiograph or CT manifestation turned into unilateral segmental consolidation, and in 23 children, bilateral sporadication and segmental consolidation became dominant. The chest radiograph was reviewed within 1 to 3 d of admission or CT, bilateral consolidation quickly developed to 26 cases (61.90%). Extrapulmonary comorbidities are mainly blood system damage (30.95%). The pathogen infection was mainly in 13 cases (30.95%) with positive Mycoplasma pneumoniae IgM. Respiratory support included nasal catheterization with oxygen in 9 cases (21.42%), noninvasive ventilation in 24 cases (57.14%), and mechanical ventilation in 9 cases (21.42%). 3 patients died during hospitalization, and 3 patients were transferred to higher-level hospitals due to critical illness. 2 of them died and 1 had severe sequelae. The remaining 36 patients (85.71%) were cured and improved.Conclusion Children with type 7 adenovirus pneumonia have high fever peaks, long heat course, significantly increased LDH and AST, rapid imaging progress, often accompanied by various damages inside and outside the lung. When clinical diagnosis of adenovirus type 7 pneumonia is suspected, the etiology should be improved as soon as possible, and the levels of LDH, AST and imaging changes should be monitored dynamically and treated as soon as possible.

参考文献/References:

[1]Jain S,Williams DJ,Arnold SR,et al.Community-acquired pneumonia requiring hospitalization among US children[J].N Engl J Med,2015,372(9):835-845. [2]Liu C,Xiao Y,Zhang J,et al.Adenovirus infection in children with acute lower respiratory tract infections in Beijing,China,2007 to 2012[J].BMC Infect Dis,2015(15):408. [3]段亚丽,朱云,徐保平,等.儿童社区获得性肺炎中人腺病毒感染的多中心研究[J].中华儿科杂志,2019,57(1):27-32. [4]Hashimoto S,Gonzalez G,Harada S,et al.Recombinant type Human mastadenovirus D85 associated with epidemic keratoconjunctivitis since 2015 in Japan[J].J Med Virol,2018,90(5):881-889. [5]中华医学会呼吸病学分会.社区获得性肺炎诊断和治疗指南[J].中国实用乡村医生杂志,2013,20(2):11-15. [6]Lynch JP,Fishbein M,Echavarria M.Adenovirus[J].Semin Respir Crit Care Med,2011,32(4):494-511. [7]汤正珍.3、7型腺病毒肺炎并发中枢神经系统疾病的机制研究[D].重庆医科大学,2018. [8]Lin MR,Yang SL,Gong YN,et al.Clinical and molecular features of adenovirus type 2,3,and 7 infections in children in an outbreak in Taiwan,2011[J].Clin Microbiol Infect,2017,23(2):110-116. [9]Li Y,Zhou W,Zhao Y,et al.Molecular typing and epidemiology profiles of human adenovirus infection among paediatric patients wi th severe acute respiratory infection in China[J].PLoS One,2015,10(4):e123234. [10]Hwang SM,Park DE,Yang YI,et al.Outbreak of febrile respiratory illness caused by adenovirus at a South Korean military training facility:clinical and radiological characteristics of adenovirus pneumonia[J].Jpn J Infect Dis,2013,66(5):359-365. [11]Spaeder MC,Fackler JC.Hospital-acquired viral infection increases mortality in children with severe viral respiratory infection[J].Pediatr Crit Care Med,2011,12(6):e317-e321. [12]余莉,武志远,洪婕,等.儿童重症腺病毒肺炎的临床研究[J].现代生物医学进展,2016,16(19):3713-3716. [13]Hong JY,Lee HJ,Piedra PA,et al.Lower respiratory tract infections due to adenovirus in hospitalized Korean children:epidemiology,clinical features,and prognosis[J].Clin Infect Dis,2001,32(10):1423-1429. [14]Myers JL,Colby TV.Pathologic manifestations of bronchiolitis,constrictive bronchiolitis, cryptogenic organizing pneumo nia,and diffuse panbronchiolitis[J].Clin Chest Med,1993,14(4):611-622. [15]Barker AF,Bergeron A,Rom WN,et al.Obliterative bronchiolitis[J].N Engl J Med,2014,370(19):1820-1828. [16]Castro-Rodriguez JA,Daszenies C,Garcia M,et al.Adenovirus pneumonia in infants and factors for developing bronchiolitis obliterans:a 5-year follow-up[J].Pediatr Pulmonol,2006,41(10):947-953.

相似文献/References:

[1]李绪定.碳青霉烯类治疗铜绿假单胞菌肺炎的临床效果分析[J].医学信息,2018,31(13):134.[doi:10.3969/j.issn.1006-1959.2018.13.039]
　LI Xu-ding.Clinical Effect of Carbapenem in the Treatment of Pseudomonas Aeruginosa Pneumonia[J].Medical Information,2018,31(02):134.[doi:10.3969/j.issn.1006-1959.2018.13.039]
[2]远 颖.黄芪注射液治疗儿童肺炎的Meta分析[J].医学信息,2019,32(02):95.[doi:10.3969/j.issn.1006-1959.2019.02.027]
　YUAN Ying.Meta-analysis of Huangqi Injection in the Treatment of Children with Pneumonia[J].Medical Information,2019,32(02):95.[doi:10.3969/j.issn.1006-1959.2019.02.027]
[3]易晓明,曾 芬.甲泼尼龙治疗SCAP的效果及其对降钙素原水平的影响[J].医学信息,2019,32(21):145.[doi:10.3969/j.issn.1006-1959.2019.21.047]
　YI Xiao-ming,ZENG Fen.Effect of Methylprednisolone on SCAP and its Effect on Procalcitonin Level[J].Medical Information,2019,32(02):145.[doi:10.3969/j.issn.1006-1959.2019.21.047]
[4]于 波.静脉注射丙种球蛋白治疗早产儿肺炎临床疗效[J].医学信息,2020,33(04):149.[doi:10.3969/j.issn.1006-1959.2020.04.048]
　YU Bo.Clinical Efficacy of Intravenous Gamma Globulin in Premature Infants with Pneumonia[J].Medical Information,2020,33(02):149.[doi:10.3969/j.issn.1006-1959.2020.04.048]
[5]郭 婷,张思琪.2019年12月~2020年3月新型冠状病毒肺炎主题研究的文献计量学分析[J].医学信息,2020,33(12):1.[doi:10.3969/j.issn.1006-1959.2020.12.001]
　GUO Ting,ZHANG Si-qi.Bibliometric Analysis of the Theme Research on Novel Coronavirus Pneumonia from December 2019 to March 2020[J].Medical Information,2020,33(02):1.[doi:10.3969/j.issn.1006-1959.2020.12.001]
[6]黄永辉,吕 刚.纤维支气管镜下注入依替米星治疗脑卒中后肺炎的疗效[J].医学信息,2020,33(15):146.[doi:10.3969/j.issn.1006-1959.2020.15.046]
　HUANG Yong-hui,LYU Gang.Efficacy of Injecting Etimicin under Fiberoptic Bronchoscopein the Treatment of Pneumonia After Stroke[J].Medical Information,2020,33(02):146.[doi:10.3969/j.issn.1006-1959.2020.15.046]
[7]马 斌,柴 智,王金虹.基于CNKI的中医诊断冠状病毒肺炎研究的文献计量学分析[J].医学信息,2020,33(21):4.[doi:10.3969/j.issn.1006-1959.2020.21.002]
　MA Bin,CHAI Zhi,WANG Jin-hong.Bibliometric Analysis of Research Literature on Diagnosis of Coronavirus Pneumonia in Chinese Medicine Based on CNKI[J].Medical Information,2020,33(02):4.[doi:10.3969/j.issn.1006-1959.2020.21.002]
[8]葛盘春.阿莫西林克拉维酸钾治疗儿童肺炎的临床疗效[J].医学信息,2022,35(06):135.[doi:10.3969/j.issn.1006-1959.2022.06.034]
　GE Pan-chun.Clinical Efficacy of Amoxicillin and Clavulanate Potassium in the Treatment of Pneumonia in Children[J].Medical Information,2022,35(02):135.[doi:10.3969/j.issn.1006-1959.2022.06.034]
[9]曹亚玲,李鹏伟,史小慧,等.张掖市0~14岁儿童肺炎的流行特征分析[J].医学信息,2024,37(12):68.[doi:10.3969/j.issn.1006-1959.2024.12.014]
　CAO Ya-ling,LI Peng-wei,SHI Xiao-hui,et al.Epidemiological Characteristics of Pneumonia in Children Aged 0-14 Years in Zhangye City[J].Medical Information,2024,37(02):68.[doi:10.3969/j.issn.1006-1959.2024.12.014]
[10]黄 婷,李玉群.床边护理联合互动式健康教育对小儿肺炎患者临床配合度及康复时间的影响[J].医学信息,2024,37(21):185.[doi:10.3969/j.issn.1006-1959.2024.21.044]
　HUANG Ting,LI Yuqun.Effect of Bedside Nursing Combined with Interactive Health Education on Clinical Cooperation and Rehabilitation Time of Children with Pneumonia[J].Medical Information,2024,37(02):185.[doi:10.3969/j.issn.1006-1959.2024.21.044]

更新日期/Last Update: 2020-01-15