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山东大学学报(医学版) ›› 2011, Vol. 49 ›› Issue (9): 136-139.

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甲型H1N1肺炎的影像学特征

林令博1,熊春梅1,李建志1,刘凯2,肖连祥2,林祥涛2   

  1. 山东大学 1.济南市传染病医院影像科, 济南 250021; 2.山东省医学影像学研究所, 济南 250021
  • 收稿日期:2010-11-19 出版日期:2011-09-10 发布日期:2011-09-10
  • 通讯作者: 林祥涛(1964- ),男,博士,副教授,主要从事影像诊断学研究。 E-mail:linxt@sdu.edu.cn
  • 作者简介:林令博(1966- ),男,硕士,主要从事影像诊断与技术研究。

Imaging characteristics of pneumonia from influenza A (H1N1) virus

LIN Ling-bo1, XIONG Chun-mei1, LI Jian-zhi1, LIU Kai2, XIAO Lian-xiang2, LIN Xiang-tao2   

  1. 1. Department of Radiology, Jinan Infectious Hospital, Shandong University, Jinan 250021, China;
    2. Shandong Medical Imaging Research Institute, Shandong University, Jinan 250021, China
  • Received:2010-11-19 Online:2011-09-10 Published:2011-09-10

摘要:

目的   探讨甲型H1N1病毒所致肺炎的影像学特征。方法   回顾性分析27例经实验室证实的甲型H1N1肺炎患者的胸部X线及CT影像学表现。结果   按照甲型H1N1病毒肺炎的受累面积,将27例患者按初诊时肺部的影像改变程度分为轻、中、重度3种类型。轻度者10例,表现为散在分布的、斑片状磨玻璃样阴影;中度者9例,表现为双肺散在分布的、多发片状实变阴影及结节影,5例合并胸腔积液,并伴有轻、中度代偿性肺气肿;重度者8例,表现为双肺大片实变阴影伴有空洞,其中2例合并霉菌球,3例伴有支气管扩张,4例合并纵隔及胸壁皮下气肿,均伴有双侧胸腔积液及中、重度肺气肿。6例死亡病例中,1例为轻度肺炎恶化死亡,1例为中度肺炎转化为重度肺炎后死亡,其他4例为重度肺炎病例。结论   甲型H1N1肺炎表现为多肺段受累的磨玻璃样变和实变,重度者常伴有空洞、支气管扩张、胸腔积液、纵隔皮下气肿及霉菌感染,死亡率高。

关键词: H1N1;肺炎;体层摄影术,X线

Abstract:

Objective   To explore imaging characteristics of pneumonia secondary to influenza A (H1N1) virus infection. Methods   Chest X-ray films and CT images were retrospectively reviewed in 27 patients with pneumonia from influenza A (H1N1) virus infection confirmed by laboratory tests. Results   According to the involved area, imaging findings were divided into 3 types:  ① mild degree manifested as scattered ground-glass opacity (GGO) in 10 patients, ② moderate degree manifested as scattered patchy consolidation or nodes in 9 patients, 5 of whom with pleural effusion, ③ severe degree manifested as patchy consolidation with cavity, pleural effusion and compensating emphysema in 8 patients, of whom 2 with mycotic infection,  3 with bronchodilatation, 4 with subcutaneous and mediastinal emphysema. Six patients died of pneumonia-related respiratory failure, including 1 case of mild degree, 1 case of moderate degree and 4 cases of severe degree. Conclusion   Pneumonia secondary to influenza A (H1N1) virus infection presents as multi-segment involved GGO and consolidation. Cavity, broncho-dilatation, pleural effusion, subcutaneous emphysema and mycotic infection, which lead to poor prognosis, are found in severe patients.

Key words: H1N1; Pneumonia; Tomography, X-ray

中图分类号: 

  • R563.1
[1] 吴倩1,丁启翠2,宋国栋1,王伟1. 老年慢性卒中后肺炎的临床特征及预后因素[J]. 山东大学学报(医学版), 2013, 51(5): 75-79.
[2] 杜黎明,周朕,王曾,谢德荣. 内科胸腔镜治疗复杂性肺炎旁胸腔积液的研究[J]. 山东大学学报(医学版), 2010, 48(9): 82-.
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