摘要
目的探讨人感染H7N9禽流感与甲型H1N1肺炎在发病初期的不同点,为临床早期干预治疗提供帮助。方法回顾性分析22例H1N1（H1N1组）和18例H7N9（H7N9组）肺炎患者的流行病史、发病年龄、基础疾病、临床表现和CT影像学资料。结果 H1N1组中位年龄23岁,基础疾病78%;H7N9组中位年龄59.5岁,基础疾病23%。在发病之初伴有呼吸困难和气促,H1N1组为9%,H7N9组为50%（P﹤0.05）。在CT肺内征象上,H7N9组磨玻璃密度影和肺实变影的共同出现率、小叶间隔增厚、胸膜增厚和薄壁空洞的表现均高于H1N1组（P﹤0.05）,其中胸膜增厚和薄壁空洞在H1N1组中未发现。结论与H1N1肺炎相比,H7N9禽流感肺炎发病年龄偏大、基础疾病偏多,CT检查能客观反映二者的影像特征,对于指导临床治疗有一定的意义。
Objective To analyze clinical features in the initial stage of viral pneumonia due to avian influenza H7N9 and Swine influenza H1N1,so as to provide help for clinical treatment. Methods The materials of age of onset,epidemiology,clinical manifestations,basic disuses and CT findings of the pneumonia in 22 patients with influenza H1N1 and 18 patients with influenza H7N9 were retrospectively analyzed. Results The median age of H7N9 patients is 23-year-old,and that of H1N1 patients is 59. 5-year-old. The percentages of the basic diseases of H7N9 patients is 78,and that of H1N1 patients is 23. The age of H7N9 patients was greater and they had more basic diseases. The onset symptoms of dyspnea and shortness of breath in H7N9 infections were more observed than that in H1N1. Morever,both groups might be accompanied by running nose,fatigue,vomiting and expectoration. In both groups,the major pathology was invasion of pulmonary parenchyma and interstitial tissue. The fundamental pulmonary CT findings were pulmonary ground-glass opacities and consolidations,air bronchogram,interlobular septum thickening,lymph lode enlargement could also be revealed. The pulmonary ground-glass opacities and consolidations appeared simultaneously in H7N9 group were observed more than that in H1N1 group,as well as the interlobular septal thickening appearance of the lung. In addition,pleural thickening and thin-walled cavities were observed in H7N9 group,however,none were found in H1N1 group. Conclusion Compared with influenza H1N1 patients,older age of onset and more underlying diseases were clinical characteristics of the patients with H7N9 avian influenza pneumonia. CT could objectively display the lung＇s imaging characteristics of the two disease for differential diagnosis,it has important purpose in guiding the initial clinical treatment.
作者
杨晨
程冰雪
周莉
曾献军
汪丽娅
YANG Chen;CHENG Bingxue;ZHOU Li(Department of Radiology,The First Affiliated Hospital of Nanehang University Nanchang,Jiangxi Province 330006,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2018年第9期1464-1468,共5页
Journal of Clinical Radiology
关键词
H7N9禽流感
甲型H1N1肺炎
鉴别
早期
H7N9 subtype avian influenza
Swine influenza H1N1 infection
Comparative
In the initial stage
