北京市2015-2019年肺炎衣原体感染患者临床特征分析  

Clinical characteristics of patients infected with Chlamydia pneumoniae in Beijing from 2015 to 2019

作　　者：罗明[1] 王雪 李爱华[1] 罗琴 谢会 李茂中[1] 王怡婷 董梅[1] 张合润[1] 龚成[1] Luo Ming;Wang Xue;Li Aihua;Luo Qin;Xie Hui;Li Maozhong;Wang Yiting;Dong Mei;Zhang Herun;Gong Cheng(Department of Immunization,Beijing Center for Disease Prevention and Control/Beijing Research Center for Preventive Medicine,Beijing 100013,China;School of Public Health of Capital Medical University,Beijing 100069,China)

机构地区：[1]北京市疾病预防控制中心免疫预防所北京市预防医学研究中心,100013 [2]首都医科大公共卫生学院,100069

出　　处：《中华预防医学杂志》2021年第8期938-944,共7页Chinese Journal of Preventive Medicine

基　　金：国家科技重大专项 (2017ZX10103004)。

摘　　要：目的分析北京市肺炎衣原体感染患者的临床特征。方法依托北京市呼吸道病原体监测系统,从全市35家不同类型的哨点医院招募急性呼吸道感染患者,采集临床标本并系统收集患者的流行病学资料、临床资料。对采集的临床标本,进行包括肺炎衣原体在内的30种(型)呼吸道病原体的核酸检测。将筛检出的肺炎衣原体感染患者分为上呼吸道感染患者和肺炎患者2组,采用独立样本t检验、Mann-Whitney U检验、χ^(2)检验或Fisher精确概率法比较2组患者临床表现、实验室检查、愈后转归等方面的差异。结果共纳入119例肺炎衣原体感染患者,其中上呼吸道感染患者12例、肺炎患者107例。81.5%(97/119)肺炎衣原体感染患者年龄介于5~44岁之间。临床主要症状为咳嗽92.4%(110/119)、发热88.8%(95/107)、咳痰76.5%(91/119)。39.3%(46/117)的肺炎衣原体感染患者白细胞计数升高,39.7%(46/116)的患者中性粒细胞百分数升高,36.9%(41/111)的患者血小板计数升高,24.5%(12/49)的患者出现肌酸激酶MB同工酶升高。影像学方面:90.6%(87/105)的肺炎衣原体肺炎患者表现为肺实质改变,病变部位常见于右肺下叶34.3%(36/105)和左肺下叶27.6%(29/105)。转归方面:73.8%(79/107)的肺炎患者住院治疗,病程天数M(P_(25),P_(75))为18.0(13.5,22.0)d,住院治疗天数M(P_(25),P_(75))为10.0(7.0,13.0)d,1例患者出现呼吸衰竭,6例患者出现心肌损伤,无患者接受重症监护室监护或机械通气治疗,无患者死亡。结论北京市2015―2019年肺炎衣原体感染患者总体症状较轻,主要症状为咳嗽、发热、咳痰,大多数肺炎衣原体肺炎患者需住院治疗,预后较好。Objective To aralyze the clinical characteristics of Chlamydia pneumoniae infection in Beijing.Methods Based on Beijing Respiratory Pathogen Surveillance System,acute respiratory infection patients were recruited from 35 different types of sentinel hospitals in Beijing.Their epidemiological and clinical data were systematically collected and clinical specimens were also obtained.Nuclear acid testing was performed for 30 types of respiratory pathogens(including Chlamydia pneumoniae).The identified patients of Chlamydia pneumoniae infection were divided into two groups,the acute upper respiratory tract infection(AURI)group and pneumoniae group.The differences in clinical characteristics,laboratory examination and prognosis were compared by using independent sample t test,Mann-Whitney U test,χ2 test or Fisher′s exact probability test.Results A total of 119 patients of Chlamydia pneumoniae infection were included,including 12 patients in the AURI group and 107 patients in pneumoniae group.Chlamydia pneumoniae infection mainly occurred in people aged from 5 to 44 years,accounting for 81.5%(97/119).The three most common clinical symptoms were cough(92.4%,110/119),fever(88.8%,95/107),and sputum production(76.5%,91/119).White blood cell counts increased in 39.3%(46/117)of patients.Neutrophile granulocyte proportion increased in 39.7%(46/116)of patients.Platelet count increased in 36.9%(41/111)of patients.An increase of the creatine kinase MB isoenzyme(CKMB)was observed in 12 pneumonia patients(24.5%,12/49).Radiological examination showed that 90.6%(87/105)of patients in the pneumoniae group had pulmonary parenchymal changes;the lesion occurred most commonly in the lower right lung lobe(34.3%,36/105)and the lower left lung lobe(27.6%,29/105).Although 73.8%(79/107)of patients in the pneumoniae group were hospitalized,no case received intensive care unit or mechanical ventilation.As to outcomes,one patient developed respiratory failure and 6 patients suffered myocardial injury.No death was observed in this study.The medi

关 键 词：肺炎衣原体 肺炎 急性上呼吸道感染 临床特征 

分 类 号：R563.1[医药卫生—呼吸系统]