10例聚集性肺炎衣原体肺炎的临床与流行病学特征  

Clinical and epidemiological characteristics of 10 cases of clustered Chlamydia pneumoniae pneumonia

作　　者：柳石磊 汪茜[1] 朱战涛 王紫云 崔晓莉 马佳佳 洪顺明 LIU Shi-lei;WANG Qian;ZHU Zhan-tao;WANG Zi-yun;CUI Xiao-li;MA Jia-jia;HONG Shun ming(The third Medical Center,Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第三医学中心急诊医学科,北京100039

出　　处：《中华医院感染学杂志》2022年第12期1890-1893,共4页Chinese Journal of Nosocomiology

基　　金：北京市海淀区健康发展科研培育计划(HP2021-20-80401)。

摘　　要：目的 探讨新冠肺炎疫情防控期间10例聚集性肺炎衣原体肺炎的诊断与临床特征。方法 回顾性分析2021年3月10日-2021年3月17日解放军总医院第三医学中心诊治的某学院10例聚集性肺炎衣原体肺炎患者临床资料,总结肺炎衣原体肺炎的临床特点,快速精准选择诊治方案。结果 10例肺炎衣原体肺炎患者均无活禽及死亡鸟类接触史;80%有咳嗽症状,50%有发热症状;实验室检查:80%白细胞计数在正常范围、60%C-反应蛋白水平有不同程度的升高、70%的患者肌酸激酶高于正常值、肌酐和降钙素原均正常、部分凝血功能指标异常。肺部CT表现为单侧肺部絮状、结节状或点团状密度增高影,可见空气支气管征,甚至实变。呼吸道五联,10例患者肺炎衣原体免疫球蛋白M(IgM)抗体均为阳性。其中2例行宏基因二代测序(mNGS),检测出肺炎衣原体的核酸序列。10例患者序贯应用盐酸莫西沙星氯化钠注射液及盐酸莫西沙星片,均治愈,1个月后门诊复查肺部CT,炎症基本吸收。结论 肺炎衣原体感染可通过呼吸道传播而引起暴发,易发生在春季。利用呼吸道病原抗体检测与mNGS技术相结合,可提高临床诊治效率。OBJECTIVE To investigate the diagnosis and clinical characteristics of 10 cases of clustered Chlamydia pneumoniae pneumonia during the prevention and control of the COVID-19 pandemic. METHODS The clinical data of 10 patients with clustered Chlamydia pneumoniae infection in a college diagnosed and treated by the Third Medical Center of the PLA General Hospital from Mar. 10, 2021 to Mar. 17, 2021 were retrospectively analyzed, the clinical characteristics of Chlamydia pneumoniae infection were summarized, and the diagnosis and treatment plan was selected quickly and accurately. RESULTS All 10 cases with Chlamydia pneumoniae pneumonia infection had no history of contact with live or dead birds, 80% of them had cough symptom, 50% of them had fever symptom. Laboratory test results showed that 80% of patients had white blood cell count in normal range, 60% of patients had increased c-reactive protein level to varying degrees, 70% of patients had creatine kinase above normal, creatinine and procalcitonin were all normal, and some coagulation function indexes were abnormal. Lung CT scan showed increased density of unilateral lung floccus, nodules or spots, with air bronchial signs and even consolidation. The results of respiratory tract five-link card showed that all 10 patients were positive for Chlamydia pneumoniae immunoglobulin M(IgM) antibody. The nucleic acid sequence of Chlamydia pneumoniae was detected by metagenomics next-generation sequencing(mNGS)in 2 patients after hospitalization. 10 patients were treated with moxifloxacin hydrochloride and sodium chloride injection and moxifloxacin hydrochloride tables in sequences, all of which were cured. After 1 month, the outpatient reexamination of lung CT showed that the inflammation was basically absorbed. CONCLUSION Chlamydia pneumoniae infection can cause outbreak through respiratory transmission, which tend to occur in the spring. The combination of respiratory pathogen antibody detection and mNGS technology can improve the efficiency of clinical diagnosis and tre

关 键 词：肺炎衣原体 肺炎 聚集病例 宏基因二代测序 临床特征 

分 类 号：R563.1[医药卫生—呼吸系统]