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投稿时间：2020-01-11 网络发布日期：2020-10-20
投稿时间：2020-01-11 网络发布日期：2020-10-20
中文摘要: 目的 基于胸部CT,分析H7N9、H1N1和H3亚型禽流感病毒肺炎患者的生存预后因素。
方法 回顾苏州大学附属第三医院自2016年12月至2018年5月收治的5例H7N9、8例H1N1及3例H3亚型禽流感病毒肺炎患者的一般资料及胸部CT影像,分析生存预后的影响因素。
结果 16例禽流感肺炎患者中,10例生存,6例死亡,死亡患者中4例H7N9,2例H1N1。与生存组比较,死亡组胸部CT易出现实变影(P=0.007)及空气支气管征(P=0.035),差异有统计学意义;年龄较小［(48.17±8.93)岁 vs(60.80±13.51)岁,t=2.025,P=0.062］,发生于H7N9较多(P=0.076),但差异无统计学意义。
禽流感病毒易累及双下肺,其中右肺更显著。死亡组较生存组,肺部病灶累及面积更广泛,更易累及全肺、右肺、右上肺、右下肺、左肺和左上肺(P<0.05,P<0.01)。肺段累及方面,死亡组较生存者更易累及右肺尖段、右肺前段、右中叶内侧段、右下肺背段、右肺后基底段、左肺上舌段、左肺下舌段和左肺后基底段(P<0.05,P<0.01)。性别、磨玻璃影、结节、小叶间隔增厚、网格影、胸腔积液及淋巴结肿大影像,两组间差异无明显统计学意义(P均>0.05)。
结论 与生存者相比,禽流感肺炎死亡患者发病年龄稍小,发于H7N9组稍多。禽流感肺炎死亡患者其胸部病灶易出现实变、空气支气管征影像特征,且病灶累及范围广泛。CT检查有利于更精确评估禽流感肺炎患者的病情及预后,进而指导治疗。
Abstract:Objective To analyze the survival prognostic factors of pneumonia caused by human infected H7N9,H1N1 and H3 avian influenza virus through chest CT feature.
Methods The general data and chest CT images of 5 cases of H7N9,8 cases of H1N1 and 3 cases of H3 pneumonia admitted to the Third Affiliated Hospital of Soochow University from December 2016 to May 2018 were reviewed,and the influencing factors of survival and prognosis were analyzed.
Results Among 16 cases of avian influenza pneumonia,6 cases died,including 4 cases of H7N9 and 2 cases of H1N1.Compared with the survival group,the consolidation (P=0.007) and air bronchogram (P=0.035) of chest CT were more likely to appear in death group.The age of death group was little younger than that of survival group without significant difference ［(48.17±8.93) years old vs (60.80±13.51)years old,t=2.025,P=0.062］.Death occurred more in H7N9 group,but the difference was not significant (P=0.076).Avian influenza virus was more likely to affect bilateral lower lungs,especially in right side.Compared with the survival group,the area of lung lesions involved in the death group was more extensive,including the whole lung,right lung,right upper lung,right lower lung,left lung and left upper lung(P<0.05,P<0.01).The death group was more likely to involve the apex of the right lung,the right anterior segment,the medial segment of the right middle lobe,the dorsal segment of the right lower lung,the posterior basal segment of the right lung,the upper lingual segment of the left lung,and the lower lingual segment of the left lung and posterior basal segment of the left lung(P<0.05,P<0.01).There was no significant difference in gender,ground glass opacity,nodules,interlobular septal thickening,grid shadow,pleural effusion and lymph node enlargement between the two groups (all P>0.05).
ConclusionsCompared with the survivors,the patients who died from avian influenza pneumonia were slghtly younger in onset age,and occurred in H7N9 a little more.The chest lesions in the death group were prone to consolidation and air bronchogram,and the lesions involved a wide range.CT examination is helpful to more accurately evaluate the condition and prognosis of patients with avian influenza pneumonia,and then guide the treatment.
文章编号： 中图分类号： 文献标志码：B
基金项目:常州市卫生健康委青年人才科技项目(QN201904)
| Author Name | Affiliation |
| BI Hui,GE Yun-qi | Department of Respiratory Medicine,the Third Affiliated Hospital of Soochow University,Changzhou,Jiangsu 213000,China |
引用文本：
毕辉,葛运起.H7N9、H1N1、H3亚型禽流感病毒肺炎的CT表现与生存预后因素分析[J].中国临床研究,2020,33(10):1373-1376.
毕辉,葛运起.H7N9、H1N1、H3亚型禽流感病毒肺炎的CT表现与生存预后因素分析[J].中国临床研究,2020,33(10):1373-1376.