肠道病毒71型感染患儿胸X线片表现

Chest X-ray findings in children with enterovirus 71 infection

摘要:

目的：研究肠道病毒71型感染患儿的胸部X线影像特点。方法：选取2010年4月至2011年7月肠道病毒71型感染患儿120例，按病情分成轻型组（31例）、重型组（43例）、危重型组（46例），对患儿发病至首次拍片时间以及首次胸部X线片影像进行比较。结果：各组发病至首次胸部X线片检查时间分别为：轻型组26~48 h（中位时间37 h）；重型组10~36 h（中位时间23 h）；危重型组2~36 h（中位时间19 h）。最早发现胸部X线片异常的时间轻型组约为发病后30 h；重型组约为发病后23 h；危重型组约为发病后2 h；3组胸部X线片最早出现异常的时间差异有统计学意义（P<0.01）。首次影像异常率：轻型组5.8%，重型组81.3%，危重型组100%，危重型组首次X线片的异常比例明显高于其他两组（P<0.01）。在胸部X线片的表现上，轻型组最常见的征象为肺纹理增粗、模糊；重型组常见表现为渗出、实变影；危重型则表现为肺水肿征像。危重型组病灶分布广，累及多个肺叶。结论：肠道病毒71型感染患儿首次胸片检查时间、胸片出现异常的时间、异常率、胸部X线片表现严重度与临床病情严重程度相关。

Abstract:

OBJECTIVE: To study the characteristics of the chest X-ray images in children infected with enterovirus 71. MethodsA total of 120 children with enterovirus 71 infection between April, 2010 and July, 2011 were classified into three groups according to the disease condition: mild (31 cases), severe (43 cases) and life-threatening (46 cases). The period from the onset of clinical symptoms to the first chest X-ray imaging examination and the results of the first chest X-ray findings were compared among the three groups. RESULTS: The period from the onset of clinical symptoms to the first chest X-ray imaging examination in the mild, severe and life-threatening groups was 26- 48 hrs (median 37 hrs), 10-36 h (median 23 hrs) and 2-36 hrs (median 19 hrs) respectively. Chest X-ray abnormalities were initially observed at 30 hrs after the onset of clinical symptoms in the mild group, at 23 hrs in the severe group and at 2 hrs in the life-threatening group (P<0.01). The mild group presented an initial imaging abnormality rate of 5.8%, the severe group 81.3% and the life-threatening group 100%. The life-threatening group showed a significantly higher initial X-ray abnormality rate than the other two groups (P<0.01). In terms of chest X-ray performance, the mild group usually presented lung marking thickening or vagueness. Most children in the severe group presented lung effusion and consolidation. Signs of pulmonary edema were found in the life-threatening group, and lesions in the life-threatening group were characterized by wide distribution and many lung lobe involvements. CONCLUSIONS: The interval between the onset of clinical symptoms and the initial chest X-ray examination, the period of time of, and the onset of clinical symptoms, at which chest X-ray abnormalities, the abnormality rate and the severity of chest X-ray findings may be paralleled to the clinical situation in children with enterovirus 71 infection.