人感染H10N3禽流感的影像学表现与病理机制分析——附2例病例报道

doi:10.19871/j.cnki.xfcrbzz.2025.02.002

新发传染病电子杂志 ›› 2025, Vol. 10 ›› Issue (2): 7-13.doi: 10.19871/j.cnki.xfcrbzz.2025.02.002

人感染H10N3禽流感的影像学表现与病理机制分析——附2例病例报道

李敏媛^1#, 单秋兰^2#, 张乐³, 覃春乐¹, 李翔^2,*, 卢亦波^1,*

1.南宁市第四人民医院（广西艾滋病临床治疗中心）放射科, 广西南宁 530023;
2.昆明市第三人民医院（云南省传染性疾病临床医学中心）医学影像科, 云南昆明 650041;
3.昆明市第三人民医院（云南省传染性疾病临床医学中心）重症医学科, 云南昆明 650041

收稿日期:2025-02-25 发布日期:2025-06-16
通讯作者: 卢亦波,Email: 13768415203@139.com;李翔,Email：15887138804@163.com
作者简介:#,共同第一作者;*,共同通信作者
基金资助:
1.广西重点研发计划（桂科AB25069097）; 2.南宁市兴宁区发展改革和科学技术局重点研发计划（2022A11）

Imaging manifestations and pathological mechanism analysis of human infection with H10N3 avian influenza virus pneumonia: a report of two cases

Li Minyuan^1#, Shan Qiulan^2#, Zhang Le³, Qin Chunle¹, Li Xiang^2,*, Lu Yibo^1,*

1. Department of Radiology, Fourth People's Hospital of Nanning, Guangxi Nanning 530023, China;
2. Department of Medical Imaging, Kunming Third People's Hospital, Yunnan Clinical Center for Infectious Diseases, Yunnan Kunming 650041, China;
3. Department of ICU, Kunming Third People's Hospital, Yunnan Clinical Medical Center for Infectious Diseases, Yunnan Kunming 650041, China

Received:2025-02-25 Published:2025-06-16

摘要/Abstract

摘要： 人感染H10N3禽流感是由H10N3亚型禽流感病毒感染所致的一种罕见呼吸道感染性疾病。禽流感病毒在禽类种群中通常表现为低致病性特征,但当发生跨种传播感染人类后,可能引发严重的病毒性肺炎临床表现,并可进一步发展为急性呼吸窘迫综合征（acute respiratory distress syndrome,ARDS）乃至多器官功能衰竭等危及生命的并发症。2021年江苏省确诊第1例人感染H10N3禽流感病例,随后在我国陆续出现3例病例。本研究基于云南及广西病例的临床资料,进行影像学表现及病理机制分析,旨在阐明人感染H10N3禽流感病毒肺炎的典型影像学表现。结果显示,该病的影像学演变具有明显的阶段性特征,可分为3个时期。①早期（发病第1~7天）：两肺出现磨玻璃影伴斑片状实变。②进展期（发病第8~20天）：实变区域扩大、融合,小叶间隔增厚及支气管充气征。③恢复期（发病第21天以后）：牵拉性支气管扩张及网格状纤维化病灶。本研究对认识人感染H10N3禽流感病毒肺炎的影像学表现、临床诊断、鉴别诊断、疗效评价及预后判断有一定的指导意义。

关键词: 人感染H10N3禽流感, 影像学特征, 病理机制, 影像学随访, 肺纤维化

Abstract: Human infection with H10N3 avian virus pneumonia is a rare respiratory infectious disease caused by H10N3 subtype avian influenza virus. While demonstrating low pathogenicity in avian populations, cross-species infection in humans may manifest as severe viral pneumonia, potentially progressing to life-threatening complications including acute respiratory distress syndrome (ARDS) and multi-organ failure. The first confirmed case of human infection with H10N3 avian influenza virus iwas reported in Jiangsu Province in 2021, followed by three more cases in China. This study conducted comprehensive analyses of imaging manifestations and underlying pathological mechanisms based on clinical data from confirmed cases in Yunnan and Guangxi regions, aiming to elucidate the characteristic imaging features of human H10N3 avian influenza virus pneumonia. The investigation revealed a triphasic temporal pattern in radiological evolution, demonstrating distinct stage-specific radiological characteristics that can be categorized into three progressive phases: ① Early stage (day 1-7 of disease progression): ground glass density with patchy consolidation appeared in both lungs. ② Progression period (day 8-20 of disease progression): enlargement and fusion of consolidation areas, thickening of interlobular septa, and air bronchogram sign. ③ Recovery period (day ≥ 21 of disease progression): tractional bronchiectasis and reticular fibrosis lesions. his study provides certain guiding significance for people in understanding the imaging manifestations, clinical diagnosis, differential diagnosis, efficacy evaluation, and prognosis judgment of human infection with H10N3 avian influenza virus pneumonia.

Key words: H10N3 avian influenza, Imaging characteristics, Pathological mechanisms, Imaging follow-up, Pulmonary fibrosis

中图分类号:

R511.7

李敏媛, 单秋兰, 张乐, 覃春乐, 李翔, 卢亦波. 人感染H10N3禽流感的影像学表现与病理机制分析——附2例病例报道[J]. 新发传染病电子杂志, 2025, 10(2): 7-13.

Li Minyuan, Shan Qiulan, Zhang Le, Qin Chunle, Li Xiang, Lu Yibo. Imaging manifestations and pathological mechanism analysis of human infection with H10N3 avian influenza virus pneumonia: a report of two cases[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(2): 7-13.

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人感染H10N3禽流感的影像学表现与病理机制分析——附2例病例报道

Imaging manifestations and pathological mechanism analysis of human infection with H10N3 avian influenza virus pneumonia: a report of two cases

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