新生儿衣原体肺炎24例临床分析  

Retrospective clinical analysis of neonatal Chlamydia trachomatis pneumonia in 24 cases

作　　者：翟倩[1] 曹云[1] 蒋思远[1] 陈超[1] 帕米尔[2] 

机构地区：[1]复旦大学附属儿科医院新生儿科,上海201102 [2]复旦大学附属儿科医院放射科,上海201102

出　　处：《中国实用儿科杂志》2012年第12期899-901,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的分析24例新生儿沙眼衣原体肺炎患儿相关临床资料,提高对新生儿沙眼衣原体肺炎的认识。方法应用实时荧光定量聚合酶链反应(PCR)检测2005年6月至2011年10月因肺炎收治复旦大学附属儿科医院新生儿科患儿呼吸道标本中的DNA,回顾性分析24例患儿的病史特点、临床表现、实验室检查、影像学特点、治疗及转归情况。结果新生儿沙眼衣原体肺炎主要表现为阵发性咳嗽、无热或低热、外周血嗜酸性粒细胞计数增高及X线胸片双肺广泛间质和(或)肺泡浸润,予红霉素或阿奇霉素治疗,均好转或治愈。初始误诊为肺结核5例,误诊率20.8%。结论新生儿衣原体肺炎无特异的临床及影像学表现,尤其是X线胸片易误诊为肺结核,应尽早行病原学检查,有利于及时诊治,减少并发症,红霉素或阿奇霉素是治疗衣原体肺炎有效的首选抗生素。Objective To analyze clinical features of neonatal Chlamydia trachomatis pneumonia to improve clinical management. Methods The data of 24 confirmed Chlamydia traehomatis cases were retrospectively reviewed, including epidemiological data, clinical manifestations, laboratory features, imaging, treatment and prognosis. Real-time poly- merase chain reaction （PCR）was conducted for detection of Chlamydia trachomatis DNA of deep respiratory samples of hospitalized children with pneumonia in Children＇s Hospital of Fudan University, from June 2005 to October 2011. Re- sults The main clinical features were： paroxysmal cough, afebrile, and increased peripheral blood eosinophil count. Chest X-ray features were extensive infiltrates of interstitial lung and （or）alveolar. After being confirmed, the patienta were treated with erythromycin or azithromycin. All the patients were cured or improved. Initially, 20.8% （5/24）of the pa- tients were misdiagnosed as tuberculosis. Conclusion Neonatal Chlamydia trachomatis pneumonia has no specific clin- ical and imaging manifestations, and is easily misdiagnosed because chest X-ray is extremely like tnberculosis. Pathogen check should be done as soon as possible to improve diagnosis and treatment and reduce complications. Erythromycin or azithromycin is the first choice of antibiotics for Chlamydia trachomatis.

关 键 词：新生儿 衣原体肺炎 

分 类 号：R72[医药卫生—儿科]