| Objectives To summarize the clinical feature of severe adenovirus pneumonia (SAP) in children and further to improve prognosis and clinical diagnosis of SAP.Methods The clinical data of213children with SAP from June2009to June2011were retrospectively analyzed.Results Among213patients,109(51.2%) children were aged6months to1years, with a males to females ratio of2.7∶1. The onset of158patients (74.2%) was in winter and spring. All patients had fever,172(80.8%) with high temperature of39.1~41℃,161(75.6%) with a feverlasting more than2weeks. Two hundred and five (96.2%) patients hadcough in the early stage,120(56.3%) with wheeze,139(65.3%) with moistrales and wheezing in the lung. Imaging findings in the preliminary stage ofSAP showed that63patients (92.6%) had pulmonary interstitial changes; incritical stage,80patients (54.4%) had segmental consolidation and33(22.4%) with pleural effusion,25(17.0%) with pleuritis; in recovery phase,50patients (68.5%) showed absorption in segmental area of consolidation.All cases had complications,175(82.2%) with respiratory failure, including10(4.7%) with ARDS; among extrapulmonary complications,diseases of cardiovascular system (64.3%) and alimentary system (44.1%)were the most common ones, and the occurrence of myocarditis anddiarrheal disease were the highest. Age, ARDS and more than two kinds ofcomplications had adverse impact on the outcomes, and the difference wassignificant (P <0.05).Conclusions SAP is a severe pneumonia with long duration of highfever, severe clinical manifestations with more complication. When SAP issuspected, it is recommended to complete etiological and chestradiographic examination for early diagnosis and treatment. Objectives To research the relationships between atopy and clinicalphenotypes of asthma in children.Methods We used a questionary to collect the clinical features of625cases of asthmatic children in our outpatient. According to thepresence of atopy,we divides them into two groups， comparing thedifference between the two groups on the clinical phenotype.Main Results （1）The average onset age of the group A and groupB were（3±0.2，3±7.3），Median age were （3years and1months，3yearsand9months），there were significant differences （P<0.05）.（2）URI were the the most common incentives to trigger asthmaattack. Exposured to allergens、Climate changes and exercise had significantdifferences in group A（P<0.05），when compared to group B.（3）Allergic diseases were often combined with SPT ove（r+++）.Theaverage total IgE were（723±512.2）IU/L in group A,while differ fromgroup B（562±501.1）IU/L.（4）Children with family history of atopic diseases were（76，26.9%)in group A，which compared to the group B（44，12.9%），there were significant differences（P<0.05）. There were also significant differences inmaternal and paternal relatives prevalence were (59.2%,40.8%).（5）FVC, FEV1was (90±19,81±20) in group A，and (82±12,75±21) in group B which has significant differences（P<0.05），after inhaledsalbutamol for15minutes,The rising percentage of FEV1were (16.7±0.012,16.7±0.09) in two groups,which were no significant difference(P>0.05). The moderate injury rates in the lung function were (4.9%,11.7%), which the difference was statistically significant (P<0.05).（6）After treat as the GINA recommended proposal，the ACT scoreswere（23.3±1.5）in group A，differ from（21.1±1.2）in group B. Comparedthe scores before and after treat，the raise scores were8.4in group A，while5.9in group B.Conclusions The onset age of atopic asthma children were earlier; inaddition to upper respiratory tract infection, exposure to allergens，climatechanges and exercise were also important factors in atopic asthmachildren.The first two allergic diseases combined with asthma were allergicrhinitis and eczema. It is important to measure total IgE when researchatopy. Atopy often combined with family history of atopic diseases, andmaternal relatives incidence were higher.; The pulmonary function injurywere more lighter when refer to atopy.Atopic asthma had high sensitivity totreatment，compared to non-atopic asthma. |
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