宏基因组二代测序诊断的鹦鹉热衣原体肺炎16例临床分析  

Clinical analysis of 16 patients with Chlamydia psittaci pneumonia diagnosed by metagenomic nextgeneration sequencing

作　　者：郑君 庞迎晨 曾超[1] 刘湘泸 徐平[1] ZHENG Jun;PANG Ying-chen;ZENG Chao;LIU Xiang-lu;XU Ping(Department of Respiratory and Critical Care Medicine,Shenzhen Hospital of Peking University,Shenzhen 518036,China;Shenzhen Bay Community Health Center of Nanshan Medical Group,Shenzhen,518067,China)

机构地区：[1]北京大学深圳医院呼吸与危重症医学科,广东深圳518036 [2]南山医疗集团总部深圳湾社康中心,广东深圳518052

出　　处：《广东医科大学学报》2023年第2期180-183,共4页Journal of Guangdong Medical University

基　　金：深圳市科创委资助项目(JCYJ20190809103203711,JCYJ20210324105411031);深圳市高水平医院建设专项经费(LCYJ2021022)。

摘　　要：目的总结肺泡灌洗液宏基因组二代测序确诊的鹦鹉热衣原体肺炎的临床特点。方法分析16例宏基因组二代测序确诊的鹦鹉热衣原体肺炎患者的临床特征、流行病学、实验室结果、治疗及预后。结果有禽类接触史9例(56.3%),发热14例(87.5%),咳嗽咳痰12例(75.0%),胸痛5例(31.3%),呼吸困难5例(31.3%),腹泻4例(25.0%),咯血2例(12.5%)、嗜睡2例(12.5%),神志不清2例(12.5%),呼吸衰竭2例(12.5%);16例(100.0%)降钙素原升高,12例(75.0%)中性粒细胞升高,6例(37.5%)肌酶升高;16例(100.0%)有肺实变;莫西沙星、多西环素、米诺环素治疗有效。结论对不明原因社区获得性肺炎患者要注意鹦鹉热衣原体肺炎可能,肺泡灌洗液宏基因组二代测序有助于其早期确诊。Objective To summarize the clinical characteristics of Chlamydia psittaci pneumonia(ChP)diagnosed by metagenomic next-generation sequencing(mNGS)of bronchoalveolar lavage fluid(BALF).Methods Clinical characteristics,epidemiology,laboratory results,treatment,and prognosis were analyzed in 16 patients with mNGS-diagnosed ChP.Results Of 16 cases,poultry exposure,fever,cough/expectoration,chest pain,dyspnea,diarrhea,hemoptysis,lethargy,confusion,and respiratory failure occurred in 9(56.3%),14(87.5%),12(75.0%),5(31.3%),5(31.3%),4(25.0%),2(12.5%),2(12.5%),2(12.5%),and 2(12.5%),respectively;procalcitonin,neutrophil and creatase were increased in 16(100.0%),12(75.0%),and 6(37.5%)respectively;and pulmonary consolidation was seen in 16(100.0%).Moxifloxacin,doxycycline and minocycline were effective.Conclusion ChP should be considered in the differential diagnosis of unexplained community-acquired pneumonia,and mNGS of BALF is helpful in its early diagnosis.

关 键 词：鹦鹉热衣原体 肺炎 肺泡灌洗液 宏基因组二代测序 

分 类 号：R563.9[医药卫生—呼吸系统]