摘要
目的:分析外周血白细胞正常或降低的社区获得性肺炎(CAP)病因及临床特点。方法:采用标准的培养技术及血清学方法检测89例白细胞不高的CAP患者呼吸道及血液标本的常见病原体,并分析其临床资料。结果:89例中军团菌属最多,占28.1%(25/89),病毒占18.0%(16/89),其中主要为流感病毒A(6例)、流感病毒B(7例),肺炎支原体占18.0%(16/89),细菌占4.3%(3/89),肺炎衣原体最少(1/89),有38.2%(34/89)的患者不能明确病原体,多种病原体混合感染占25.8%。病毒性肺炎、军团菌肺炎及肺炎支原体肺炎的临床症状、体征、外周血白细胞、胸部影像均无特异性,其鉴别须靠病原微生物检查。结论:外周血白细胞正常或降低的CAP病因主要为非典型病原体和病毒,对这类CAP的经验治疗应以大环内酯类抗生素或抗病毒药物为主。
Objective: To investigate the microbial aetiology and clinic features of leukopenia or normal leucocyte community acquired pneumonia (CAP). Methods: The common pathogen of respiratory tract and blood was measured by standard culture techniques and new serological detection in 89 cases with CAP who had leukopenia or normal leucocyte,clinic data were collected prospectively. Results:Of the 89 cases Legionella pneumophila infection was the highest(28.1%,25/89), viral infection (18. 0% ,16/89) , the main pathogens were influenza A virus and influenza B virus, Mycoplasma pneumoniae(18. 0% ,16/89), other bacterial pathogens (4.3%, 3/89), Chlamydia pneumoniae (1/89). Aetiological agents could not identified from 34 (38.2%) patients. Mixed infections rate was 25.8%. Clinic symptom and sign are nonspecific in viral pneumonia,Legionnaires pneumonia and mycoplasmal pneumoniae, also WBC and chest X-ray,differential diagnosis rely on microbiological diagnosis. Conclusions: Atypical pathogens and virus are main causes of CAP with leukopenia or normal leucocyte, empirical therapy should select macrolide or ami-virus drugs.
出处
《中国临床医学》
2004年第2期156-158,共3页
Chinese Journal of Clinical Medicine
