Zhang Xin-Ping, Yang Mei-Yu, Zhou Xiong, Cao Jian-She, Cai Zi-Li, Kang Xia-Yan, Xie Bo, Liu Ying, He Jie, Xiao Zheng-Hui
Emergency Center, Hunan Children's Hospital, Changsha 410007, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2020 May;22(5):429-434. doi: 10.7499/j.issn.1008-8830.1911174.
To study the clinical features of severe type 7 adenovirus pneumonia in children.
A retrospective analysis was performed for the clinical data of children who were diagnosed with severe type 7 adenovirus pneumonia from February to June, 2019.
Among the 45 children, the male/female ratio was 3:2 and the median age was 14 months. All children had repeated fever, cough, and pulmonary moist rales, and the mean duration of fever was 14±4 days. The median time from fever to dyspnea was 8 days, and the time from fever to mechanical ventilation was 11.6±2.5 d. There was no significant increase in white blood cell count, with neutrophils as the main type. There were slight reductions in hemoglobin and albumin, while platelet and fibrinogen remained normal. There were increases in aspartate aminotransferase, lactate dehydrogenase, procalcitonin, and C-reaction protein. The detection rate of mixed pathogens was 84%. Effusion in both lungs was the major change on chest imaging (64%). Bronchoscopic manifestations were endobronchitis, tracheomalacia, and plastic bronchitis. The incidence rate of respiratory complications was 100%, and extrapulmonary complications mainly involved the circulatory system (47%), digestive system (36%), and nervous system (31%). Among the 45 children, 16 were administered with 400 mg/kg intravenous immunoglobulin (IVIG) daily for 5 days, with a mean duration of fever of 16±5 days, and 29 were administered with 1 g/kg IVIG daily for 2 days, with a mean duration of fever of 13±4 days; there was a significant difference in the mean duration of fever between the two groups (P=0.046). The overall mortality rate was 11%.
Severe type 7 adenovirus pneumonia in children has severe conditions, with a high incidence rate of complications and a high mortality rate, so it should be diagnosed and treated as early as possible.
研究儿童重症7型腺病毒肺炎的临床特征。
对2019年2月至6月诊断为重症7型腺病毒肺炎的儿童临床资料进行回顾性分析。
45例患儿中，男/女比例为3∶2，中位年龄为14个月。所有患儿均有反复发热、咳嗽及肺部湿啰音，平均发热持续时间为14±4天。发热至呼吸困难的中位时间为8天，发热至机械通气的时间为11.6±2.5天。白细胞计数无明显升高，以中性粒细胞为主。血红蛋白和白蛋白略有降低，血小板和纤维蛋白原保持正常。天门冬氨酸氨基转移酶、乳酸脱氢酶、降钙素原及C反应蛋白升高。混合病原体检出率为84%。胸部影像学主要表现为双肺渗出（64%）。支气管镜表现为支气管炎、气管软化及塑形性支气管炎。呼吸并发症发生率为100%，肺外并发症主要累及循环系统（47%）、消化系统（36%）及神经系统（31%）。45例患儿中，16例每日静脉滴注400 mg/kg静脉注射免疫球蛋白（IVIG），共5天，平均发热持续时间为16±5天；29例每日静脉滴注1 g/kg IVIG，共2天，平均发热持续时间为13±4天；两组平均发热持续时间差异有统计学意义（P=0.046）。总死亡率为11%。
儿童重症7型腺病毒肺炎病情严重，并发症发生率及死亡率高，应尽早诊断及治疗。
