Objective To observe the clinical manifestations of 24 patients with severe ade-novirus pneumonia(SAdVP) in order to achieve early recognition of the severe type of the disease. Methods Clinical data of 24 cases with SAdVP caused by respiratory serotype 7 adenovirus infec-tion, such as clinical features, image data, biochemical indicator and complications were analyzed retrospectively, and compared with 42 mild pneumonia cases. Results Twenty-four cases were the first batch patients admitted to our hospital after the outbreak of epidemic with pneumonia severity index (PSI) of 69. 75±8. 24. Compared with mild cases,severe cases had higher fever with a tem-perature reaching and severe cough.The duration of high fever was range 12～24 days. Abnormal vi-tal signs, hypoxemia occured in 28 cases. In 29 severe cases, CT showed lobar or segmental consoli-dation with ground glassopacity ( GGO) . Progression of chest CT manifested as extension and newly emerging of multi-shaped lesions which characterized by a large range of GGO damage.In admission, leukocytosis and elevation of neutrophils in 25 cases, thrombocytopnea in 5 cases compared with those of mild cases (P<0. 05). Conclusion Persistent hyperpyrexia and severe cough, lobar le-sions and large areas of GGO in chest CT, decreased oxygenation index, thrombocytopenia and ab-normal liver function are main features before deterioration of patients suffering from adenovirus pneumonia.%目的 分析重症腺病毒肺炎患者的临床特征,确定成人重症腺病毒肺炎的早期评估方法.方法 回顾性分析24例7型腺病毒呼吸道感染致重症腺病毒肺炎患者的临床资料,总结咳嗽评分、咳嗽时间、影像资料、生化指标及并发症,并就以上指标与42例轻症患者进行比较.结果 24例重症腺病毒肺炎患者危重症评分为(69.75±8.24)分,表现高热和剧烈咳嗽,发热持续时间12～24(16.21±6.54)d.66例中生命体征异常和低氧血症28例,胸部CT示叶、段性的实变伴毛玻璃影29例,影像学上进展多表现为大片实变为主的病灶,可出现范围迅速扩大、密度增高和多种不同形态的新发病灶,入院白细胞计数、中性粒细胞增高25例,血小板计数减少5例(血小板计数重症组与轻症组比较,P<0.05).结论 持续高热并咳嗽评分>2分,胸部CT出现大片实变和迅速进展为大叶性病灶,氧合指数降低,血小板减少,肝功能异常,是成人腺病毒肺炎向重症发展早期的主要特点.
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