成人腺病毒感染临床特征与高敏 C-反应蛋白变化的意义

目的 观察成人腺病毒感染后的临床特征与血清高敏C-反应蛋白（hs-CRP）的变化,探讨hs-CRP变化的临床意义.方法 选择2012年3～4月在解放军第三二三医院住院的成人腺病毒呼吸道感染者37例（腺病毒组）及普通病毒组（流行性腮腺炎、水痘）40例,分析其临床特点及血清hs-CRP变化.将腺病毒组分为轻症组15例（发热时间≤4 d）和重症组22例（发热时间≥5d）,比较两组hs-CRP、白细胞（WBC）、中性粒细胞百分比（GR％）水平.结果 ①成人腺病毒感染后有多系统受损,临床特征为高热、眼球结膜充血、咽部白色分泌物.②发病3d内及1周时,腺病毒组血清hs-CRP水平分别为（26.4±18.1）、（10.2±9.6）mg/L,显著高于普通病毒组血清hs-CRP水平（11.8±9.6）、（4.6±2.6） mg/L],差异有高度统计学意义（P＜0.01）.③发病3d内腺病毒组与普通病毒组在hs-CRP的分层比较,差异有高度统计学意义（x2=11.71,P＜ 0.01）.④发病3d内腺病毒组中轻症组hs-CRP、GR％均明显高于重症组,差异有高度统计学意义（P＜0.01）;轻症组与重症组WBC水平比较,差异无统计学意义（P＞0.05）.结论 成人腺病毒感染后,有较特异的临床特征.hs-CRP可作为病情轻重的观察指标.依据hs-CRP的升高可疑混合细菌感染加用抗菌药物时,要综合分析后决定.

Clinical features and significance of high sensitivity C-reactive protein in adult patients with adenovirus infection

Objective To observe the clinical features of adult adenorirus respiratory tract infection and the changes of serum sensitivity C-reactive protein （hs-CRP）,to investigate the clinical significance of hsCRP change.Methods 37 cases of adult adenovirus respiratory infections in the 323rd Hospital of PLA from March to April 2012 were selected as adenovirus group,40 cases of mumps,chicken pox were chosen as common virus group; clinical characteristics and hs-CRP were analyzed.The adenovirus group was divided into mild group with 15 cases （fever time ≤4 days） and severe group with 22 cases （fever time ≥ 5 days）; hs-CRP,WBC,GR% between the two groups were compared.Results ①The clinical characteristics of adult adenorirus infection were severe fever,eye membrane hypermia and pharyngeal white secreta.②hs-CRP levels in adenovirus group within 3 days and 1 week of onset were （26.4±18.1） mg/L and （10.2±9.6） mg/L respectively,they were all higher than those in common virus group （11.8±9.6）,（4.6±2.6） mg/L],the differences were statistically significant （P 〈 0.01）.③The differences of hs-CRP hierarchy within 3 days of onset between the adenovirus group and common virus group were statistically significant （x2 =11.71,P 〈 0.01）.④hs-CRP,GR% in mild group within 3 days of onset were all higher than those in severe group,the differences were statistically significant （P 〈 0.01）; the difference of WBC level between the severe group and mild group was not statistically significant （P 〉 0.05）.Conclusion Patients of adult adenovirus infection have relative specific clinical features.hsCRP can be used as an observation index for the severity of adenovirus infection.On the basis of increased hs-CRP,only after having evidence of bacterial infection,can antimicrobial drugs be used.