婴儿沙眼衣原体肺炎185例临床特征分析  

Clinical Features of 185 Infants with Chlamydia Trachomatis Pneumonia

作　　者：孟庆清[1] 张光莉[1] 张慧[1] 陈明[1] 田琴琴[1] 王维[1] 王龙伦 罗征秀[1] Meng Qingqing;Zhang Guangli;Zhang Hui;Cheng Ming;Tian Qinqin;Wang Wei;Wang Longlun;Luo Zhengxiu(Children＇ s Hospital of Chongqing Medical University, Chongqing 400014, China)

机构地区：[1]重庆医科大学附属儿童医院,重庆400014

出　　处：《儿科药学杂志》2018年第7期10-13,共4页Journal of Pediatric Pharmacy

基　　金：国家临床重点专科建设项目;编号2011-873

摘　　要：目的:分析沙眼衣原体肺炎临床特征,以期为沙眼衣原体肺炎早期诊治提供参考。方法:回顾性分析我院2015年1月至12月诊治的185例沙眼衣原体肺炎住院患儿的临床资料。结果:185例患儿中男女比例为1.43∶1,<3月龄发病者170例(91.9%),顺产163例(88.1%)。185例患儿发热77例(41.6%),咳嗽183例(98.9%),其中痉挛性咳嗽26例(14.2%),138例(74.6%)可闻及密集细湿啰音,67例(36.2%)可闻及哮鸣音。113例(77.3%)嗜酸粒细胞增高。合并检出病原以革兰阴性菌为主,优势菌分别为大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌。胸部X线以双肺弥漫性实质病变为主,高分辨率CT(HRCT)以近胸膜下小叶性实变(98.0%)和节段性实变(48.0%)和树芽征(36.0%)最常见。9例(4.9%)合并结膜炎。156例(84.3%)患儿给予阿奇霉素抗感染治疗,1例(0.5%)患儿行机械辅助通气,所有患儿预后良好,无死亡病例。结论:沙眼衣原体肺炎好发于3月龄以下小婴儿,经阴道分娩是主要感染途径,临床上可有痉挛性咳嗽,常合并嗜酸粒细胞升高,HRCT以肺节段性实变及近胸膜下小叶性实变为主。经阿奇霉素抗感染及积极对症治疗均预后良好。Objective： To analyze the clinical features of Chlamydia trachomatis pneumonia,so as to provide reference for early diagnosis and treatment of Chlamydia trachomatis pneumonia. Methods： Retrospective analysis was conducted on clinical data of 185 children with Chlamydia trachomatis pneumonia admitted into Children＇s Hospital of Chongqing Medical University from Jan. to Dec.2015. Results： Among the 185 patients,the gender proportion was 1. 43 ∶ 1（ male to female）,170（ 91. 9%） patients attacked within3 months old,and 163（ 88. 1%） babies were delivered vaginally. Seventy-seven（ 41. 6%） patients underwent fevers and 183（ 98. 9%）cases with coughed,of which 26（ 14. 2%） patientshad with spasmodic cough,138（ 74. 6%） patients had dense fine wet rales and 67（ 36. 2%） cases had wheezing rales. Blood test showed eosinophilia in 113（ 77. 3%） patients. Gram-negative bacteria were the main pathogens detected,most of which were E. coli,Klebsiella pneumoniae,and Enterobacter cloacae. The chest X-ray showed diffuse parenchymal lesions in lungs. Subpleural lobular consolidation（ 98. 0%）,segmental consolidation（ 48. 0%） and tree-in-bud（ 36. 0%）were dominantly found in HRCT examination. Nine（ 4. 9%） patients were accompanied with conjunctivitis. One hundred and fifty-six patients received azithromycin. And 1（ 0. 5%） patient received assisted mechanical ventilation. All patients had admirable prognosis and no death case was fund. Conclusion： Chlamydia trachomatis pneumonia mostly occurs in infants within 3-months-olds. Vaginal delivery is the main way to get infected. Spasmodic cough,combined with increased blood esnophils,are main clinical manifestations;subpleural lobular consolidation and segmental consolidation are mostly found in HRCT examination. All patients have good prognosis after azithromycin and positive symptomatic treatments.

关 键 词：沙眼衣原体肺炎 婴儿 临床表现 高分辨率CT 

分 类 号：R725.6[医药卫生—儿科]