CAJ | 학술논문

目的通过对成人腺病毒B组7型感染者的资料进行归纳、分析,以期总结规律,提高诊治水平,便于早期诊断和及时控制疫情.方法收集2012年12月至2013年2月收治的301例成人腺病毒B组7型感染病例,开展流行病学调查,记录症状、体征、相关实验室检测结果,以及影像学表现等临床资料,并采集咽拭子,以实时定量聚合酶链反应(RT-PCR)法检测病毒核酸查找病原体.结果疫情主要集中在12月至次年2月份.301例患者中,男277例,女24例,年龄15～29岁,平均年龄为(19.1±1.9)岁,流行病学调查显示患者均有居住于同一宿舍或同一餐厅就餐等密切接触史.主要临床症状包括发热(100.0％)、咳嗽(70.4％)、咳痰(48.2％)、咽痛(47.8％),部分病例伴头痛、头晕、畏寒、乏力等.主要体征为咽部充血(62.5％),其次为扁桃体增大(43.5％)、咽部淋巴滤泡增生(26.6％),部分患者扁桃体表面被覆白色分泌物.75例患者胸部影像学检查异常,以轻症肺炎为主,伴或不伴周围渗出性病变和胸腔积液.实验室检查显示,99.0％患者外周血白细胞计数偏高或正常,54.2％患者中性粒细胞升高,80.7％单核细胞升高,67.1％淋巴细胞比例降低,42.2％患者C反应蛋白水平升高.平均病程为(6.6±2.9)d.利巴韦林辅以热毒宁静脉滴注,同时加强对症支持治疗.所有患者均治愈出院,无死亡.结论成人腺病毒B组7型传染性强,群体流行,冬季高发.感染者多数症状较轻,主要表现为发热、咳嗽、咳痰和咽痛,病程短.经过及时、积极治疗,预后良好.
목적 통과대성인선병독B조7형감염자적자료진행귀납、분석,이기총결규률,제고진치수평,편우조기진단화급시공제역정.방법 수집2012년12월지2013년2월수치적301례성인선병독B조7형감염병례,개전류행병학조사,기록증상、체정、상관실험실검측결과,이급영상학표현등림상자료,병채집인식자,이실시정량취합매련반응(RT-PCR)법검측병독핵산사조병원체.결과 역정주요집중재12월지차년2월빈.301례환자중,남277례,녀24례,년령15～29세,평균년령위(19.1±1.9)세,류행병학조사현시환자균유거주우동일숙사혹동일찬청취찬등밀절접촉사.주요림상증상포괄발열(100.0％)、해수(70.4％)、해담(48.2％)、인통(47.8％),부분병례반두통、두훈、외한、핍력등.주요체정위인부충혈(62.5％),기차위편도체증대(43.5％)、인부림파려포증생(26.6％),부분환자편도체표면피복백색분비물.75례환자흉부영상학검사이상,이경증폐염위주,반혹불반주위삼출성병변화흉강적액.실험실검사현시,99.0％환자외주혈백세포계수편고혹정상,54.2％환자중성립세포승고,80.7％단핵세포승고,67.1％림파세포비례강저,42.2％환자C반응단백수평승고.평균병정위(6.6±2.9)d.리파위림보이열독저정맥적주,동시가강대증지지치료.소유환자균치유출원,무사망.결론 성인선병독B조7형전염성강,군체류행,동계고발.감염자다수증상교경,주요표현위발열、해수、해담화인통,병정단.경과급시、적겁치료,예후량호.
Objective To investigate the clinical characteristics of patients infected with human adenovirus type 7 and to provide guidance for early diagnosis and timely control of the outbreak.Methods A total of 301 patients infected with the human adenoviruses who were quarantined in hospital from December 2012 to February 2013 were observed.Epidemiological questionnaires were used to collect data of clinical features of the disease including symptoms,signs,images and laboratory tests.To confirm infection,real time polymerase chain reaction was performed using patients' swabs to detect viral nucleotide.Results Most cases happened in December to the next February.Totally 277 cases of the 301 patients were male,and only 24 cases were female.Mean age was (19.1±1.9) years old,range 15 to 29 years old.Identifiable epidemiologic links were seen between patients.The most common symptoms were fever (100.0％),cough (70.4％),expectoration (48.2％),and sore throat (47.8％).In addition,some patients presented with headache,dizziness,chills,fatigue.The most common signs were pharyngeal congestion (62.5％),enlargement of tonsils (56.5％) and lymphatic follicular hyperplasia (26.6％).Some patients' tonsil was covered with white secretions.Lung images were abnormal in 75 cases,which were presented with mild pneumonia with or without surrounding exudative lesions and pleural effusion in lung images.Laboratory tests showed that the number of white blood cells in the peripheral blood in most of the patients (99.0 ％) was elevated or normal.The proportions of neutrophils (54.2％) and monocytes (80.7％) and the level of C-reactive protein (42.2％) increased,while the proportion of lymphocytes reduced (67.1％).The average course of disease was (6.6±2.9) d.With the treatment of intravenous ribavirin and reduning,all patients were cured.Conclusions Human adenovirus type 7 is quite contagious and may cause epidemic outbreak,especially in winter.The majority exhibits mild symptoms of upper respiratory tract infection with short duration,including fever,cough,expectoration and sore throat.Through timely and active treatment,all patients have a good prognosis.