CAJ | 학술논문

目的：探讨深圳地区儿童感染后闭塞性细支气管炎(BO)的病原、临床及影像学特点。方法回顾分析2009年6月至2014年7月我院35例诊断为BO的临床及影像资料，总结其病因、临床特点、肺功能及影像学特点。结果年龄(2.1±1.6)岁，男25例，女10例。病原学检测：腺病毒10例，肺炎支原体10例，麻疹4例，呼吸道合胞病毒、甲型H1N1流感病毒、副流感病毒各1例，混合感染1例。5例病原不明。临床表现为反复或持续性喘息(35例)、咳嗽(33例)、活动后气促(15例)，持续或反复细湿罗音(30例)，三凹征(26例)，口周发绀(4例)。35例肺部HRCT结果：充气不均31例，磨玻璃影26例，马赛克灌注征30例，空气滞留征8例，支气管壁增厚19例，支气管扩张4例，网格影3例，合并肺实变13例，合并肺不张5例。Swyer-James综合征1例。28例肺功能检查均异常：24例为小气道阻塞性通气功能障碍，4例混合性通气功能障碍。结论腺病毒和肺炎支原体是深圳地区儿童感染后BO的主要病原，结合典型的临床表现、肺部HRCT和肺功能特点可以明确诊断BO。
목적：탐토심수지구인동감염후폐새성세지기관염(BO)적병원、림상급영상학특점。방법회고분석2009년6월지2014년7월아원35례진단위BO적림상급영상자료，총결기병인、림상특점、폐공능급영상학특점。결과년령(2.1±1.6)세，남25례，녀10례。병원학검측：선병독10례，폐염지원체10례，마진4례，호흡도합포병독、갑형H1N1류감병독、부류감병독각1례，혼합감염1례。5례병원불명。림상표현위반복혹지속성천식(35례)、해수(33례)、활동후기촉(15례)，지속혹반복세습라음(30례)，삼요정(26례)，구주발감(4례)。35례폐부HRCT결과：충기불균31례，마파리영26례，마새극관주정30례，공기체류정8례，지기관벽증후19례，지기관확장4례，망격영3례，합병폐실변13례，합병폐불장5례。Swyer-James종합정1례。28례폐공능검사균이상：24례위소기도조새성통기공능장애，4례혼합성통기공능장애。결론선병독화폐염지원체시심수지구인동감염후BO적주요병원，결합전형적림상표현、폐부HRCT화폐공능특점가이명학진단BO。
Objective To investigate the clinical and HRCT characteristic of post-infectious bronchiolitis obliterans (BO) in children in Shenzhen City.Methods Clinical and HRCT data of 35 cases with post-infectious BO between June 2009 and July 2014 were retrospectively analyzed. Features of etiology, clinical data, pulmonary function and radiology were summarized.Results 35 patients consisted of 25 boys and 10 girls with mean age of (2.1±1.6) years. Previous infection pathogens included adenovirus (n=10), mycoplasma (n=10), measles virus (n=4), respiratory syncytial virus (n=1), H1N1 infuenza virus (n=1), parainfluenza virus (n=1) and mixed infection (n=1). The etiology was unknown in 5 cases. Most common clinical manifestations were repeated or persistent wheezing (n=35), cough (n=33), short of breath (n=15), crackles (n=30), retraction (n=26) and cyanosis (n=4). Major HRCT findings of 35 cases were as follows: incomplete aeration in 31 cases, mosaic perfusion in 26 cases, air trapping in 8 cases, bronchial wall thickening in 19 cases, bronchiectasis in 4 cases, reticular opacity in 3 cases, consolidation in 13 cases, atelectasis in 5 cases and Swyer-James syndrome in 1 case. 28 cases underwent pulmonary function test with abnormal results: constrictive obstruction in small airway in 24 cases and mixed pattern in the other 4 cases.Conclusions Adenovirus and mycoplasma were the two leading pathogens of post-infectious BO in Shenzhen City. According to the clinical manifestations, abnormal lung function and HRCT findings, post-infectious BO can be diagnosed correctly in an early stage.