CAJ | 학술논문

目的探讨人感染H7N9禽流感病毒性肺炎的肺部影像学表现、动态变化及鉴别诊断。方法收集福建省立医院2013年1月至2014年2月收治的3例确诊为人感染H7N9禽流感病毒性肺炎的临床影像学资料(男3例)，对其影像学表现进行分析。结果3例患者均以发热、咳嗽、咳痰为首发症状，超敏C反应蛋白明显升高。3例中，1例表现为单叶实变影，1例表现为双肺多叶实变影伴间质性改变，1例表现为单叶实变影伴斑片状影及磨玻璃改变。病变特点：两肺多叶、多段受累，病变具有游走性，进展期实变影增多，病灶吸收缓慢，可出现肺纤维化。3例均见不同程度胸膜反应伴胸腔积液；未见肺门及纵隔淋巴结肿大。结论 H7N9禽流感病毒性肺炎的临床及影像学表现有一定特点，胸部X线检查是最基本的影像学检查方法，可显示病变密度、形态和范围以及变化情况，有助于判断病情，指导治疗和估计预后。
목적탐토인감염H7N9금류감병독성폐염적폐부영상학표현、동태변화급감별진단。방법수집복건성립의원2013년1월지2014년2월수치적3례학진위인감염H7N9금류감병독성폐염적림상영상학자료(남3례)，대기영상학표현진행분석。결과3례환자균이발열、해수、해담위수발증상，초민C반응단백명현승고。3례중，1례표현위단협실변영，1례표현위쌍폐다협실변영반간질성개변，1례표현위단협실변영반반편상영급마파리개변。병변특점：량폐다협、다단수루，병변구유유주성，진전기실변영증다，병조흡수완만，가출현폐섬유화。3례균견불동정도흉막반응반흉강적액；미견폐문급종격림파결종대。결론 H7N9금류감병독성폐염적림상급영상학표현유일정특점，흉부X선검사시최기본적영상학검사방법，가현시병변밀도、형태화범위이급변화정황，유조우판단병정，지도치료화고계예후。
Objective To investigate the imaging features of the pneumonia caused by human infection with H7N9 subtype origin influenza virus.Method The clinical and imaging data of 3 patients(3 men ) with H7N9 subtype avianorigin influenza were collected in Fujian Province hospital from Jan 18,2013 to Feb,2014,and the clinical imaging manifestations were analyzed.Result In 3 cases,1 presented consolidation in the right lung, inferior lobe;1 showed consolidation in both lungs, inferior lobe in accompany with interstitial changes;1 showed multilobar consolidation with patchy opacity and ground glass opacity (GGO).Multiple lobes,multiple segments in both lungs were involved with wandering lesions.The consolidation increased with slow absorption in the period of progress and pulmonary fibrosis may appear. Pleural reactions and effusions occurred in all the 3 cases without enlargement of hilum of lung and mediastinal lymph nodes.Conclusion H7N9 subtype human avian influenza carries some certain clinical and imaging characteristics.Chest radiography is an elementary imaging means of choice for detecting the disease which can distinctly demonstrate the dynamic changes of the density,shape,and range of pulmonary lesions.It is helpful for assessing the disease condition,planning the therapy and evaluating the prognosis.