摘要
目的分析四川地区鹦鹉热衣原体肺炎患者的临床特征及治疗方案,为临床诊治提供参考。方法对成都市第二人民医院2020年12月至2023年2月收治的通过宏基因二代测序(mNGS)确诊的24例鹦鹉热衣原体肺炎患者进行回顾性分析。结果患者主要以发热为首要表现,其他临床症状包括畏寒、寒战、头晕、头痛、乏力、咳嗽、咳痰、肌肉酸痛等,主要并发症为急性呼吸衰竭和肝功能不全,胸部CT多呈单侧肺叶炎性改变,一半以上患者出现胸腔积液。采用多西环素、氟喹诺酮类单药或联合用药的方案进行抗感染治疗后预后良好,联合用药在退热时间上优于单药治疗,但是不能缩短住院时间和用药疗程。结论鹦鹉热衣原体肺炎患者多有鸟类接触史。对不明原因社区获得性肺炎患者应仔细询问其流行病学史,同时结合患者的临床表现、实验室检查和影像学检查对疑似鹦鹉热的患者尽早通过mNGS技术进行辅助诊断。多西环素和氟喹诺酮类药物在鹦鹉热衣原体肺炎患者的治疗中有效,联合用药能使患者体温更快恢复正常。
Objective To analyze the clinical characteristics and treatment of Chlamydia psittaci pneumonia(C.psittaci pneumonia)patients in Sichuan,and to provide reference for clinical diagnosis and treatment.Methods We retrospectively analyzed of 24 patients with C.psittaci pneumonia confirmed by metagenomic next-generation sequencing(mNGS)admitted to Chengdu Second People’s Hospital from December 2020 to February 2023.Results The main manifestations of patients were fever.Other clinical symptoms included chills,dizziness,headache,fatigue,cough,sputum and myalgia,etc.The main complications were acute respiratory failure and hepatic insufficiency.Chest CT scans showed unilateral pulmonary inflammatory changes,and pleural effusion occurred in more than half of the patients.The prognosis was good after the anti-infection therapy with doxycycline and fluoroquinolone single or combined administration.The combination therapy was superior to monotherapy in reducing fever,but it failed to shorten hospitalization time and medication course.Conclusion Most patients with C.psittaci pneumonia have a history of exposure to birds.Patients with unexplained community-acquired pneumonia should be carefully questioned about their epidemiological history.At the same time,mNGS technology should be combined with the clinical manifestations,laboratory examination and imaging examination to diagnose suspected patients with psittacosis as soon as possible.Doxycycline and fluoroquinolones are effective for C.psittaci pneumonia,and combined medication helps patients recover to their normal body temperature more quickly.
作者
周燕
邹娅
卢鋆
郭西芮
邹雍维
叶永琴
刘欢
李刚
ZHOU Yan;ZOU Ya;LU Yun;GUO Xi-rui;ZOU Yong-wei;YE Yong-qin;LIU Huan;LI Gang(Department of Clinical Pharmacy,Chengdu Second People’s Hospital,Chengdu 610021;Department of Respiratory and Critical Care Medicine,Chengdu Second People’s Hospital,Chengdu 610021;Sichuan Provincial Transportation Hospital,Chengdu 611731;Department of Medical Equipment,Sichuan Provincial People’s Hospital,Chengdu 610072)
出处
《中南药学》
CAS
2024年第3期778-783,共6页
Central South Pharmacy
基金
国家重点研发计划课题(No.2020YFC2005506)。
关键词
鹦鹉热衣原体肺炎
社区获得性肺炎
肺泡灌洗液
宏基因二代测序
Chlamydia psittaci pneumonia
community-acquired pneumonia
bronchoalveolar lavage fluid
metagenomic next-generation sequencing
