| 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。 |
| 关键词: 沙眼衣原体肺炎 婴儿 临床表现 高分辨率CT |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2018.07.003 |
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| 基金项目:国家临床重点专科建设项目,编号2011-873。 |
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| Clinical Features of 185 Infants with Chlamydia Trachomatis Pneumonia |
| 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) |
| Abstract: |
| 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 within 3 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. |
| Key words: chlamydia trachomatis pneumonia infants clinical manifestations HRCT |
