青壮年腺病毒B组55型重症肺炎临床特征分析

目的总结青壮年腺病毒B组55型重症肺炎的临床特点。方法对我科2013年4—5月收治的6例腺病毒B组55型重症肺炎患者的临床资料进行回顾性分析。结果6例均为青壮年男性，年龄25—40岁，均来自河北省保定市。临床症状重，均有高热、咳嗽、咳痰、呼吸困难，部分出现精神异常等肺外表现。6例外周血c-反应蛋白、白细胞介素6、中性粒细胞比例均升高，白细胞计数可降低、正常或升高。血生化以丙氨酸氨基转移酶、天冬氨酸氨基转移酶、乳酸脱氢酶升高及白蛋白降低为特征。胸部CT以多肺叶受累的肺大片实变为主要特征，并可出现空洞、纵隔气肿、皮下积气等。经抗感染、应用糖皮质激素、气管插管辅助通气等综合治疗，4例好转出院，2例死亡。结论青壮年腺病毒B组55型重症肺炎病情进展迅速、病程较长、病死率高，临床医师应对其予以重视，及早进行积极的抢救。

Clinical characteristics of severe human adenovirus type 55 pneumonia

Objective To summarize the clinical characteristics of severe human adenovirus type 55 pneumonia. Methods Clinical data about 6 patients with severe human adenovirus type 55 pneumonia admitted to our department from April 2013 to May 2013 were retrospectively analyzed. Results The 6 patients were adult males aged 25-40 years from Baoding, Hebei Province. Their clinical symptoms included fever, cough, expectoration, and dyspnea with mental symptoms appeared in some of them. Their serum CRP and IL6 level and neutrophils were higher while their white blood cells were lower, normal or elevated. Laboratory test demonstrated that their serum alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase levels were higher while their serum albumin level was lower. Chest CT showed large pulmonary consolidation, cavities, mediasfinal emphysema, and subcutaneous pneumatosis, etc. Of the 6 patients, 4 were discharged and 2 died after anti-infection and glucocorticoid treatment, and endotracheal intubation-assisted ventilation, etc. Conclusion Severe human adenovirus type 55 pneumonia in adults progresses rapidly with a long course and a high mortality, and should be treated as soon as possible.