中华临床感染病杂志
中華臨床感染病雜誌
중화림상감염병잡지
CHINESE JOURNAL OF CLINICAL INFECTIOUS DISEASES
2013年
3期
162-165
,共4页
胡舟朝%王秋景%柴能明%王和平%丁贤君%李绍佐%李世波
鬍舟朝%王鞦景%柴能明%王和平%丁賢君%李紹佐%李世波
호주조%왕추경%시능명%왕화평%정현군%리소좌%리세파
布尼亚病毒科感染%发热%血小板减少%体层摄影术,X线计算机
佈尼亞病毒科感染%髮熱%血小闆減少%體層攝影術,X線計算機
포니아병독과감염%발열%혈소판감소%체층섭영술,X선계산궤
Bunyaviridae infections%Fever%Thrombocytopenia%Tomography,X-ray computed
目的 观察新型布尼亚病毒感染者肺部CT影像学特征,并分析其与临床指标变化的关系.方法 选取2011年5月至2012年8月浙江省舟山医院和岱山医院收治经浙江省疾病预防控制中心确诊并出现肺部影像学表现的19例新型布尼亚病毒感染者.所有患者在病程初期、极期及恢复期行肺部CT检查,动态观察患者白细胞(WBC)、血小板(PLT)、淋巴细胞(主要是CD4+T淋巴细胞)的变化,采用重复测量资料的方差分析及LSD对数据进行处理,并分析其值与肺部影像学之间的关系.结果 19例肺部影像学异常表现者中,磨玻璃影13例,结节影5例,网格状表现3例,胸膜增厚粘连5例,纵隔淋巴结肿大3例;其中16例为双侧肺部受累,3例为单侧受累;11例合并胸腔积液.15例出现明显肺部病变的患者WBC、PLT和CD4+T淋巴细胞在病程不同期间的数值差异具有统计学意义(F =20.21,28.37和32.92,P值均＜0.01),在病程极期数值最低,分别为(1.6±0.6)×109/L,(26.0±9.1)×109/L和(100.0 ±66.2)×106/L,经过适当治疗后,均恢复正常,且肺部CT均显示为病灶完全吸收,无后遗症.结论 新型布尼亚病毒感染者肺部CT表现与临床指标变化有一定关联,尽早治疗预后良好.
目的 觀察新型佈尼亞病毒感染者肺部CT影像學特徵,併分析其與臨床指標變化的關繫.方法 選取2011年5月至2012年8月浙江省舟山醫院和岱山醫院收治經浙江省疾病預防控製中心確診併齣現肺部影像學錶現的19例新型佈尼亞病毒感染者.所有患者在病程初期、極期及恢複期行肺部CT檢查,動態觀察患者白細胞(WBC)、血小闆(PLT)、淋巴細胞(主要是CD4+T淋巴細胞)的變化,採用重複測量資料的方差分析及LSD對數據進行處理,併分析其值與肺部影像學之間的關繫.結果 19例肺部影像學異常錶現者中,磨玻璃影13例,結節影5例,網格狀錶現3例,胸膜增厚粘連5例,縱隔淋巴結腫大3例;其中16例為雙側肺部受纍,3例為單側受纍;11例閤併胸腔積液.15例齣現明顯肺部病變的患者WBC、PLT和CD4+T淋巴細胞在病程不同期間的數值差異具有統計學意義(F =20.21,28.37和32.92,P值均＜0.01),在病程極期數值最低,分彆為(1.6±0.6)×109/L,(26.0±9.1)×109/L和(100.0 ±66.2)×106/L,經過適噹治療後,均恢複正常,且肺部CT均顯示為病竈完全吸收,無後遺癥.結論 新型佈尼亞病毒感染者肺部CT錶現與臨床指標變化有一定關聯,儘早治療預後良好.
목적 관찰신형포니아병독감염자폐부CT영상학특정,병분석기여림상지표변화적관계.방법 선취2011년5월지2012년8월절강성주산의원화대산의원수치경절강성질병예방공제중심학진병출현폐부영상학표현적19례신형포니아병독감염자.소유환자재병정초기、겁기급회복기행폐부CT검사,동태관찰환자백세포(WBC)、혈소판(PLT)、림파세포(주요시CD4+T림파세포)적변화,채용중복측량자료적방차분석급LSD대수거진행처리,병분석기치여폐부영상학지간적관계.결과 19례폐부영상학이상표현자중,마파리영13례,결절영5례,망격상표현3례,흉막증후점련5례,종격림파결종대3례;기중16례위쌍측폐부수루,3례위단측수루;11례합병흉강적액.15례출현명현폐부병변적환자WBC、PLT화CD4+T림파세포재병정불동기간적수치차이구유통계학의의(F =20.21,28.37화32.92,P치균＜0.01),재병정겁기수치최저,분별위(1.6±0.6)×109/L,(26.0±9.1)×109/L화(100.0 ±66.2)×106/L,경과괄당치료후,균회복정상,차폐부CT균현시위병조완전흡수,무후유증.결론 신형포니아병독감염자폐부CT표현여림상지표변화유일정관련,진조치료예후량호.
Objective To review pulmonary CT imaging features and their correlations with the changes on clinical indexes in patients infected with severe fever with thrombocytopenia syndrome bunyavirus (novel bunyavirus).Methods Clinical data and pulmonary CT findings of 19 patients infected with the novel bunyavirus in Zhoushan Hospital and Daishan Hospital of Zhejiang Province during May 2011 and August 2012 were collected.Infection of the novel bunyavirus was confirmed by Zhejiang Provincial Center for Disease Control and Prevention (CDC).All patients received high resolution CT scanning at initial period,critical period and recovery period.And the changes on WBC,platelet (PLT) and lymphocytes (mainly CD4 + T lymphocytes) were observed.Repeated measures analysis of variance and least significant difference (LSD) were performed,and correlation between the changes on clinical parameters and pulmonary imaging was studied.Results In pulmonary CT images,13 out of 19 cases presented groundglass shadow,5 cases presented consolidation shadow,3 cases presented retisculation,5 cases presented pleural thickening and adhesion,and 3 cases presented mediastinal lymphadenopathy.Sixteen patients presented the involvement of bilateral lungs and 3 patients unilateral.Pleural effusion was observed in 11 cases.There were significant differences in WBC,PLT and CD4+T count among initial,critical and recovery periods in 15 patients with obvious lung lesions (F =20.21,28.37 and 32.92,P ＜0.01).And the above indexes dropped to the lowest points during critical period,which were (1.6 ± 0.6) x 109/L,(26.0 ±9.1) x 109/L and (100.0 ± 66.2) x 106/L,respectively.After treatment,pulmonary CT scan showed that the foci were completely absorbed and no sequelae were observed.Conclusion The changes on pulmonary CT imaging are correlated with those of clinical indexes in novel bunyavirus infection,and the prognosis is good if patients receive the appropriate treatment in the early stage.
