Please wait a minute...
浙江大学学报（医学版）
浙江大学学报（医学版）  2019, Vol. 48 Issue (5): 567-572    DOI: 10.3785/j.issn.1008-9292.2019.10.16
综述     
儿童重症腺病毒肺炎早期识别的研究进展
林静(),陈志敏*()
浙江大学医学院附属儿童医院 国家儿童健康与疾病临床医学研究中心, 浙江 杭州 310052
Research progress on early identification of severe adenovirus pneumonia in children
LIN Jing(),CHEN Zhimin*()
The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China
 全文: PDF(748 KB)   HTML( 15 )
摘要：

重症腺病毒肺炎患儿具有较高的病死率及后遗症发生率。儿童重症腺病毒肺炎以发热、咳嗽为主要症状，无明显特异性。一般来说，对于处于好发年龄及流行季节内的儿童，出现持续高热不退，应早期完善腺病毒病原学检测、血常规、细胞因子、T细胞亚群等检测及影像学检查。其中，影像学检查发现早期表现为肺段及大叶实质浸润、明显肺气肿、间质性肺炎改变或合并大量胸腔积液的患儿，应警惕为重症腺病毒肺炎。本文综述了腺病毒肺炎不同季节、地区、血清学的流行病学特点，重症腺病毒肺炎的高危因素、实验室检测及影像学早期表现，以期为重症腺病毒肺炎的早期识别提供参考。
关键词： 腺病毒感染, 人/流行病学;  儿童;  肺炎, 病毒性/诊断;  危险因素;  综述    
Abstract:

Severe adenovirus pneumonia has a high mortality and incidence of sequelae. Fever and cough are the main symptoms of children's severe adenovirus pneumonia, but such clinical manifestations are lack of specificity. For children with persistent high fever who are in the epidemic age and season, the adenovirus etiology detection, blood routine, cytokines, T cell subsets and imaging examinations are suggested. Children with early manifestations of infiltration of lung segment and lobar parenchyma, obvious emphysema, interstitial pneumonia or a large amount of pleural effusion should be alerted to have severe adenovirus pneumonia. This article reviews the epidemiological characteristics and risk factors of adenovirus pneumonia in different seasons, regions and serology, and the laboratory findings and imaging features of severe adenovirus pneumonia, which would be helpful for the early identification of the disease.
Key words: Adenovirus infections, human/epidemiology    Child    Pneumonia, viral/diagnosis    Risk factors    Review
收稿日期: 2019-07-08 出版日期: 2020-01-04
:  R725.6  
通讯作者: 陈志敏     E-mail: 21718455@zju.edu.cn;zmchen@zju.edu.cn
作者简介: 林静(1994-), 女, 硕士, 住院医师, 主要从事儿童呼吸道感染性疾病研究; E-mail:21718455@zju.edu.cn; https://orcid.org/0000-0001-7527-5234
服务　　
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章　　
林静
陈志敏

引用本文:

林静,陈志敏. 儿童重症腺病毒肺炎早期识别的研究进展[J]. 浙江大学学报（医学版）, 2019, 48(5): 567-572.

LIN Jing,CHEN Zhimin. Research progress on early identification of severe adenovirus pneumonia in children. J Zhejiang Univ (Med Sci), 2019, 48(5): 567-572.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2019.10.16    或    http://www.zjujournals.com/med/CN/Y2019/V48/I5/567

1 张其威.人呼吸道腺病毒感染的流行、预防和治疗[C].广州: 2018新发传染病研究热点研讨会, 2018: 1.
ZHANG Qiwei. Prevalence, prevention and treatment of human respiratory adenovirus infection[C]. Guangzhou: 2018 symposium on emerging infectious diseases, 2018: 1. (in Chinese)
2 潘丽峰, 傅慧琴, 崔琪奇 et al. 上海市浦东新区引起腹泻的腺病毒分子流行病学特征[J]. 职业与健康, 2019, 35 (2): 176- 179
PAN Lifeng , FU Huiqin , CUI Qiqi et al. Molecular epidemiology characterization analysis of diarrhea caused by adenovirus in Pudong new district of Shanghai[J]. Occupation and Health, 2019, 35 (2): 176- 179
3 FADEN H , WILBY M , HAINER Z D et al. Pediatric adenovirus infection: relationship of clinical spectrum, seasonal distribution, and serotype[J]. Clin Pediatr (Phila), 2011, 50 (6): 483- 487
doi: 10.1177/0009922810392775
4 BRANDT C D , KIM H W , VARGOSKO A J et al. Infections in 18000 infants and children in a controlled study of respiratory tract disease: Ⅰ. Adenovirus pathogenicity in relation to serologic type and illness syndrome[J]. Am J Epidemiol, 1969, 90 (6): 484- 500
doi: 10.1093/oxfordjournals.aje.a121094
5 崔小文 . 小儿重症腺病毒肺炎混合感染特征及高危因素分析[J]. 当代医学, 2017, 23 (24): 16- 18
CUI Xiaowen . Analysis of mixed infection characteristics and risk factors of severe adenovirus pneumonia in children[J]. Contemporary Medicine, 2017, 23 (24): 16- 18
doi: 10.3969/j.issn.1009-4393.2017.24.007
6 胡亚美, 江载芳 . 诸福棠实用儿科学[M]. 8版 北京: 人民卫生出版社, 2015.
HU Yamei , JIANG Zaifang . Practical pediatrics[M]. 8th ed Beijing: people's medical publishing house, 2015.
7 王和平, 郑跃杰, 赵海霞 et al. 25602例住院儿童呼吸道腺病毒感染检出分析[J]. 重庆医学, 2018, 47 (12): 1661- 1663
WANG Heping , ZHENG Yuejie , ZHAO Haixia et al. Analysis of respiratory adenovirus infection in 25, 602 hospitalized children[J]. Chongqing Medicine, 2018, 47 (12): 1661- 1663
doi: 10.3969/j.issn.1671-8348.2018.12.023
8 冯晓妍, 吴敏 . 人腺病毒感染流行病学研究进展[J]. 医学动物防制, 2016, 32 (5): 518- 520
FENG Xiaoyan , WU Min . Progress in the epidemiology of human adenovirus infection[J]. Journal of Medical Animal Control, 2016, 32 (5): 518- 520
9 陈伟, 秦珑, 王盛书 et al. 某学校一起呼吸道腺病毒7型暴发疫情调查与处置[J]. 军事医学, 2017, 12 (41): 994- 997
CHEN Wei , QIN Long , WANG Shengshu et al. Investigation and management of an outbreak of respiratory adenovirus type 7 in a school[J]. Military Medicine, 2017, 12 (41): 994- 997
10 焦素黎, 倪红霞, 陈冰冰 et al. 一起腺病毒引起的小学呼吸道感染聚集性疫情调查和实验室检测[J]. 中国卫生检验杂志, 2018, 21 (28): 2646- 2648
JIAO Suli , NI Hongxia , CHEN Bingbing et al. Investigation and laboratory test of a case of respiratory tract infection caused by adenovirus in primary school[J]. Chinese Journal of Health Laboratory, 2008, 21 (28): 2646- 2648
11 MEI Y F , SKOG J , LINDMAN K et al. Comparative analysis of the genome organization of human adenovirus 11, a member of the human adenovirus species B, and the commonly used human adenovirus 5 vector, a member of species C[J]. J Gen Virol, 2003, 84 (Pt 8): 2061- 2071
12 CHEHADEH W , AL-ADWANI A , JOHN S E et al. Adenovirus types associated with severe respiratory diseases: A retrospective 4-year study in Kuwait[J]. J Med Virol, 2018, 90 (6): 1033- 1039
doi: 10.1002/jmv.25059
13 XU L , LIU J , LIU C et al. Case-control study of the epidemiological and clinical features of human adenovirus 55 and human adenovirus 7 infection in children with acute lower respiratory tract infections in Beijing, China, 2008-2013[J]. BMC Infect Dis, 2018, 18 (1): 634
doi: 10.1186/s12879-018-3520-z
14 杜芳, 黄英, 舒畅 et al. 小儿重症腺病毒肺炎混合感染及高危因素分析[J]. 中国当代儿科杂志, 2013, 15 (5): 375- 378
DU Fang , HUANG Ying , SHU Chang et al. Mixed infection and risk factors analysis of severe adenovirus pneumonia in children[J]. Chinese Journal of Contemporary Pediatrics, 2013, 15 (5): 375- 378
15 阮继锋, 温敏宜 . 小儿重症腺病毒肺炎混合感染特征及高危因素分析[J]. 深圳中西医结合杂志, 2016, 26 (10): 15- 16
RUAN Jifeng , WEN Minyi . Analysis of mixed infection characteristics and risk factors of severe adenovirus pneumonia in children[J]. Shenzhen Journal of Integrated Traditional Chinese and Western Medicine, 2016, 26 (10): 15- 16
16 罗力妍, 饶花平, 徐畅 et al. 儿童重症腺病毒肺炎危险因素分析[J]. 中国中西医结合儿科学, 2014, 6 (6): 549- 550
LUO Liyan , RAO Huaping , XU Chang et al. Risk factors analysis of severe adenovirus pneumonia in children[J]. Pediatrics of Integrated Traditional Chinese and Western Medicine in China, 2014, 6 (6): 549- 550
doi: 10.3969/j.issn.1674-3865.2014.06.029
17 郑申健, 胡俊, 汪珍珍 et al. 重度腺病毒肺炎患儿预后不良相关危险因素[J]. 中国感染控制杂志, 2016, 15 (8): 587- 591
ZHENG Shenjian , HU Jun , WANG Zhenzhen et al. Risk factors associated with poor prognosis in children with severe adenovirus pneumonia[J]. Chinese Journal of Infection Control, 2016, 15 (8): 587- 591
doi: 10.3969/j.issn.1671-9638.2016.08.012
18 XIE L , ZHANG B , ZHOU J et al. Human adenovirus load in respiratory tract secretions are predictors for disease severity in children with human adenovirus pneumonia[J]. Virol J, 2018, 15 (1): 123
doi: 10.1186/s12985-018-1037-0
19 刘爱良, 黄英, 杨洋 et al. 儿童重症腺病毒肺炎213例临床特征分析[J]. 临床儿科杂志, 2013, 31 (8): 726- 729
LIU Ailiang , HUANG Ying , YANG Yang et al. Analysis of 213 cases of severe adenovirus pneumonia in children[J]. Journal of Clinical Pediatrics, 2013, 31 (8): 726- 729
doi: 10.3969/j.issn.1000-3606.2013.08.007
20 王佳伟.重症腺病毒肺炎患儿T细胞亚群及细胞因子水平变化及其临床意义的研究[D].杭州: 浙江大学, 2018.
WANG Jiawei. Changes and clinical significance of t-cell subsets and cytokines in children with severe adenovirus pneumonia [D]. Hangzhou: Zhejiang University, 2018. (in Chinese)
21 郑丽丽, 许航燕, 应旦红 et al. 重症腺病毒肺炎患儿T细胞亚群变化及其临床意义的研究[J]. 浙江医学, 2018, 40 (15): 1702- 1704
ZHENG Lili , XU Hangyan , YING Danhong et al. Changes and clinical significance of t-cell subsets in children with severe adenovirus pneumonia[J]. Zhejiang Medical Journal, 2008, 40 (15): 1702- 1704
22 LAI C Y, LEE C J, LUC Y, et al. Adenovirus serotype 3 and 7 infection with acute respiratory failure in children in Taiwan, 2010-2011[J/OL]. PLoS One, 2013, 8(1): e53614.
23 婧奕, 王斐, 徐婷婷 et al. 儿童重症监护病房重症腺病毒肺炎特点和救治方法探讨[J]. 中国小儿急救医学, 2019, 26 (3): 190- 194
JING Yi , WANG Fei , XU Tingting et al. Characteristics and treatment of severe adenovirus pneumonia in pediatric intensive care unit[J]. Chinese Pediatric Emergency Medicine, 2019, 26 (3): 190- 194
doi: 10.3760/cma.j.issn.1673-4912.2019.03.007
24 党润, 艾斌, 杨镒宇 et al. 儿童重症腺病毒肺炎不同阶段的临床影像学特征[J]. 分子影像学杂志, 2018, 41 (4): 426- 430
DANG Run , AI Bin , YANG Yiyu et al. Clinical imaging characteristics of severe adenovirus pneumonia in children at different stages[J]. Journal of Molecular Imaging, 2008, 41 (4): 426- 430
25 李晶, 岳学静, 郭喜霞 et al. 重症腺病毒肺炎患儿临床特征及CT诊断分析[J]. 中国CT和MRI杂志, 2019, 17 (3): 1- 4
LI Jing , YUE Xuejing , GUO Xixia et al. Clinical characteristics and CT diagnosis analysis of children patients with severe adenovirus pneumonia[J]. Chinese Journal of CT and MRI, 2019, 17 (3): 1- 4
doi: 10.3969/j.issn.1672-5131.2019.03.001
[1] 张军浩,金静华,杨巍. 自噬调控血管平滑肌细胞功能在颅内动脉瘤形成和破裂中的作用[J]. 浙江大学学报（医学版）, 2019, 48(5): 552-559.
[2] 陈钿雨,祁鸣. 单亲二体及其在癌症中的作用研究进展[J]. 浙江大学学报（医学版）, 2019, 48(5): 560-566.
[3] 麦合木提江·穆扎帕,周敏. 腹主动脉瘤腔内修复术中髂内动脉封堵后盆腔缺血症状发生的危险因素[J]. 浙江大学学报（医学版）, 2019, 48(5): 546-551.
[4] 徐佳俊,舒强. 三维打印技术在先天性心脏病中的应用[J]. 浙江大学学报（医学版）, 2019, 48(5): 573-579.
[5] 黄淑敏,赵正言. 重症联合免疫缺陷病新生儿筛查及免疫系统重建研究进展[J]. 浙江大学学报（医学版）, 2019, 48(4): 351-357.
[6] 陈光杰,王晓豪,唐达星. 性别发育异常的评估、诊断和治疗研究进展[J]. 浙江大学学报（医学版）, 2019, 48(4): 358-366.
[7] 张建民. 缺血性脑血管疾病手术治疗新进展[J]. 浙江大学学报（医学版）, 2019, 48(3): 233-240.
[8] 吴雨星, 张世红, 陈忠. 缰核及其神经环路在神经精神疾病中的作用研究进展[J]. 浙江大学学报（医学版）, 2019, 48(3): 310-317.
[9] 张韵竹, 朱春鹏, 陆新良. 胃癌早期诊断的血清生物学标志物研究进展[J]. 浙江大学学报（医学版）, 2019, 48(3): 326-333.
[10] 陶安阳, 王志敏, 陈红芳, 徐冬娟, 胡海芳, 吴承龙, 张晓玲, 马小董, 王亚仙, 胡海涛, 楼敏, 浙江省缺血性脑卒中静脉溶栓的临床行为干预研究协作组 . 合并心房颤动对缺血性脑卒中患者静脉溶栓后颅内出血转化的影响[J]. 浙江大学学报（医学版）, 2019, 48(3): 254-259.
[11] 朱紫菱, 谈静, 邓红. 肿瘤细胞膜/质蛋白转位入核研究进展[J]. 浙江大学学报（医学版）, 2019, 48(3): 318-325.
[12] BabooKalianee Devi,陈正云,张信美. 子宫腺肌病患者药物治疗进展[J]. 浙江大学学报（医学版）, 2019, 48(2): 142-147.
[13] 吴彬彬,杨毅. 心脏手术相关急性肾损伤早期生物学标志物研究进展[J]. 浙江大学学报（医学版）, 2019, 48(2): 224-229.
[14] 杨坤,胡晓晟. 微小RNA-21在心脏疾病中的研究进展[J]. 浙江大学学报（医学版）, 2019, 48(2): 214-218.
[15] 徐力,许鸣,童向民. 有氧糖酵解在非霍奇金淋巴瘤发病及耐药机制中的作用[J]. 浙江大学学报（医学版）, 2019, 48(2): 219-223.