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目的探讨无免疫缺陷婴儿巨细胞病毒肺炎的临床特点及治疗方法。方法回顾性分析10例无明显免疫缺陷巨细胞病毒肺炎患儿的临床资料。结果本组病程1~4周;患儿入院时均有咳嗽症状;合并发热4例,呼吸急促3例,湿性啰音8例,哮鸣音5例,鼻翼扇动及三凹征2例;胸部CT检查示肺实质性病变3例,肺实质与间质均受累7例(其中2例以间质为主);9例给予不同疗程更昔洛韦治疗,1例给予静脉用丙种球蛋白治疗后临床症状明显改善;出院2~3个月患儿肺部影像病灶明显吸收,6个月时均恢复正常。结论无免疫缺陷婴儿巨细胞病毒肺炎表现为常规治疗后咳嗽、喘息等呼吸道症状不改善,影像学以肺实质合并间质改变为主,应用更昔洛韦治疗有效。
Objective To investigate the clinical characteristics and treatment of infantile cytomegalovirus pneumonia without immunodeficiency. Methods The clinical data of 10 children without obvious immunodeficiency cytomegalovirus pneumonia were retrospectively analyzed. Results The course of disease ranged from 1 to 4 weeks. All children had cough during admission. In 4 patients with fever, 3 cases had shortness of breath, 8 cases with wet rales, 5 cases with wheeze, 2 cases with nasal flap and trochanter; CT showed pulmonary parenchymal lesions in 3 cases, pulmonary parenchyma and stroma were involved in 7 cases (2 cases of interstitial-based); 9 cases were treated with different courses of ganciclovir, 1 case of intravenous administration of gamma globulin After clinical symptoms improved significantly; 2 to 3 months after discharge of children with pulmonary lesions were significantly absorbed, 6 months were returned to normal. Conclusions Immunocompromised infants with cytomegalovirus pneumonitis showed no improvement of respiratory symptoms such as cough and wheezing after routine treatment. Imaging mainly consisted of pulmonary parenchyma with interstitial changes, and the treatment with ganciclovir was effective.