CAJ | 학술논문

目的总结儿童2009甲型H1N1流感的胸部X线影像特点.方法选取2009年5月1日至2010年1月31日经首都儿科研究所病毒研究室病原学检测确诊且影像学资料完整的2009甲型H1N1流感患儿235例,按病情分为轻度组(172例)、中度组(49例)、重度组(14例),对患儿发病至首次拍片时间以及首次胸X线片影像表现进行比较.三组间性别、影像表现差异使用χ2检验.患儿年龄及发病至首次拍片时间的比较使用非参数检验.结果各组患儿年龄、性别差异无统计学意义(P＞0.05).3组发病至拍摄胸X线片的时间分别为:轻度组(5.91±1.64)d,中度组(3.60±1.43)d,重度组(1.21±0.41)d,3组间差异有统计学意义(χ2=13.368,P＜0.01).首次胸X线片影像异常率:轻度组79.7%,中度组91.8%,重度组100.0%,在胸X线片表现上,各组出现肺纹理粗重、模糊(轻度组55.2%,中度组83.7%,重度组78.6%),肺实变(轻度组34.3%,中度组69.4%,重度组100.0%),肺过度充气(轻度组22.1%,中度组44.9%,重度组50.0%)以及磨玻璃密度影(轻度组0.6%,中度组2.0%,重度组14.3%)的比例差异均有统计学意义(P＜0.01).重度组病灶分布广、不对称,累及多个肺叶.结论儿童2009甲型H1N1流感首次胸X线片出现异常时间、异常率、胸X线片表现严重度与临床病情严重程度成正比.
목적 총결인동2009갑형H1N1류감적흉부X선영상특점.방법 선취2009년5월1일지2010년1월31일경수도인과연구소병독연구실병원학검측학진차영상학자료완정적2009갑형H1N1류감환인235례,안병정분위경도조(172례)、중도조(49례)、중도조(14례),대환인발병지수차박편시간이급수차흉X선편영상표현진행비교.삼조간성별、영상표현차이사용χ2검험.환인년령급발병지수차박편시간적비교사용비삼수검험.결과 각조환인년령、성별차이무통계학의의(P＞0.05).3조발병지박섭흉X선편적시간분별위:경도조(5.91±1.64)d,중도조(3.60±1.43)d,중도조(1.21±0.41)d,3조간차이유통계학의의(χ2=13.368,P＜0.01).수차흉X선편영상이상솔:경도조79.7%,중도조91.8%,중도조100.0%,재흉X선편표현상,각조출현폐문리조중、모호(경도조55.2%,중도조83.7%,중도조78.6%),폐실변(경도조34.3%,중도조69.4%,중도조100.0%),폐과도충기(경도조22.1%,중도조44.9%,중도조50.0%)이급마파리밀도영(경도조0.6%,중도조2.0%,중도조14.3%)적비례차이균유통계학의의(P＜0.01).중도조병조분포엄、불대칭,루급다개폐협.결론 인동2009갑형H1N1류감수차흉X선편출현이상시간、이상솔、흉X선편표현엄중도여림상병정엄중정도성정비.
Objective To evaluate chest radiographic findings of children with 2009 influenza ( H1N1 ) virus infection. Method Data of 235 patients who had microbiologically confirmed H1N1 infection and available chest radiograph obtained between May 1st 2009 and Jan. 31st 2010 were retrospectively analyzed. The final study group was divided on the basis of clinical course [group 1 mild, outpatients without hospitalization ( n = 172 ); group 2 moderate, inpatients with brief hospitalization ( n = 49 ); group 3 severe, ICU admission (n = 14)]. Four pediatric radiologists reviewed all the chest radiographs of lung parenchyma, airway, pleural abnormalities and also anatomic distribution of the disease. Result No significant sex or age differences were found among the study groups ( P ＞0.05 ). The mean interval between the onset of clinical symptom and the initial chest radiography was (5.91 ± 1. 64) days (group 1 ), (3.60 ±1.43 ) days ( group 2) and ( 1.21 ± 0.41 ) days ( group 3 ), respectively. The differences among the three groups were significant statistically ( χ2 = 13.368, P ＜ 0.01 ). The ratio of abnormality presented at initial chest X-ray was 79.7% in group 1,91.8% in group 2 and 100% in group 3. Radiographically, there were prominent peribronchial markings ( group 1, 55.2%; group 2, 83.7%; and group 3, 78.6% ),consolidation ( group 1, 34.3%; group 2, 69.4%; and group 3, 100.0% ), hyperinflation ( group 1,22.1%; group 2, 44.9%; and group 3, 50.0% ) and ground glass opacity ( group 1, 0.6%; group 2,2.0%; and group 3, 14.3% ) in the chest radiographs. The differences of presenting were statistically significant (P ＜0.01 ). In the severe group, the lesions distributed diffusely and asymmetrically with multi lobe involvements. Conclusion In children with 2009 influenza A H1N1 viral infection, the interval between the onset of clinical symptom and initial chest radiography, the ratio of abnormality presented at initial chest X-ray film and the severity of chest film are parallel to their clinical situation.