CAJ | 학술논문

目的：探讨儿童巨细胞病毒(CMV)肺炎伴多脏器损害的临床特点。方法：对120例儿童巨细胞病毒(CMV)肺炎伴多器官损害儿童的临床资料进行回顾性分析。结果：120例儿童CMV肺炎中80例(66.7%)为婴儿(0~1岁)；临床以低热、咳嗽、喘息、呼吸困难为主要表现，肺部体征不明显；92例肺外器官损害中，1岁以下婴儿72例(78.3%)，1~3岁14例(15.2%)，>3岁6例(6.5%)；多器官损害以消化、血液、心血管系统多见，分别为87.0%、27.2%、26.1%；更昔洛韦(GCV)治疗后，痊愈102例(85.0%)，好转18例(15.0%)。辅助检查：120例患儿血清CMV-IgM均阳性且CMV-DNA定量检测阳性。85例(70.8%)胸部X线以肺间质改变为主。结论：儿童巨细胞病毒肺炎多发生在1岁以内，其临床症状、体征及胸部X线缺乏特异性，常伴肺外器官受损，易误诊误治，采用更昔洛韦治疗安全有效。
목적：탐토인동거세포병독(CMV)폐염반다장기손해적림상특점。방법：대120례인동거세포병독(CMV)폐염반다기관손해인동적림상자료진행회고성분석。결과：120례인동CMV폐염중80례(66.7%)위영인(0~1세)；림상이저열、해수、천식、호흡곤난위주요표현，폐부체정불명현；92례폐외기관손해중，1세이하영인72례(78.3%)，1~3세14례(15.2%)，>3세6례(6.5%)；다기관손해이소화、혈액、심혈관계통다견，분별위87.0%、27.2%、26.1%；경석락위(GCV)치료후，전유102례(85.0%)，호전18례(15.0%)。보조검사：120례환인혈청CMV-IgM균양성차CMV-DNA정량검측양성。85례(70.8%)흉부X선이폐간질개변위주。결론：인동거세포병독폐염다발생재1세이내，기림상증상、체정급흉부X선결핍특이성，상반폐외기관수손，역오진오치，채용경석락위치료안전유효。
Objective:To investigate clinical features of cytomegalovirus(CMV) pneumonia accompanied with multiple organ damage in children. Method:The clinical data of 120 cases with cytomegalovirus(CMV) pneumonia accompanied with multiple organ damage in children were retrospectively analyzed. Result:A total of 80 cases(66.7%) in 120 cases with CMV pneumonia were infants(0-1 years old).The major clinical manifestations were low heat,cough, wheezing,difficult breathing.Pulmonary symptoms were not obvious.There were 92 cases of extrapulmonary organ damage in all children,including 72 cases(78.3%) of 1-year-old,14 cases(15.2%) of 1-3 years old,6 cases(6.5%) of more than 3 years old.The major multiple damaged organs were the digestive system,blood, and the cardiovascular system.Its rates respectively were 87%,27.2%,26.1%.After treated with ganciclovir(GCV),102 cases(85.0%) were cured,18 cases(15.0%) improved.Auxiliary examination:120 cases of children were serum CMV-IgM positive and CMV-DNA positive in quantitative detection.There were 85 cases(70.8%) in lung interstitial changes in chest X-rays.Conclusion:Cytomegalovirus pneumonia in children mostly occurred within 1-year-old.The clinical symptoms,signs and chest X-rays lack specificity.This disease often accompanies with extrapulmonary organ damage,and is easily misdiagnosed.Ganciclovir in the treatment of this disease is safe and effective.