11例鹦鹉热衣原体肺炎的宏基因二代测序诊断及临床特征分析
Journal: Basic Medical Theory Research DOI: 10.32629/bmtr.v8i2.18858
Abstract
目的：总结鹦鹉热衣原体肺炎的临床症状、辅助检查及治疗，提高内科医生对该疾病的早期诊断，及时治疗。方法：回顾义乌天祥东方医院、横店文荣医院从2020年09月到2025年10月的11例鹦鹉热衣原体肺炎的患者，通过支气管镜获取的肺泡灌洗液，宏基因组学二代测序（mNGS）技术确诊，对其临床特点、胸部CT的影像学表现、实验室检查、肺泡灌洗液（BALF）的mNGS和病理结果及治疗药物进行分析。结果：11例病人中女性占5例，男6例，年龄 37～79岁，中位年龄58岁。症状主要先高热（11/11），后咳嗽（9/11）。白细胞总数正常（10/11）、降低（1/11），淋巴细胞计数降低（9/11），CRP 升高（11/11），PCT 正常（8/11）、轻度升高（2/11）、明显升高（1/11），心肌酶谱浓度上升（6/11），所有病例的胸部CT均呈现出沿肺段分布的斑片渗出实变影。病理描述为炎性改变，均为炎症细胞浸润伴纤维素渗出。经mNGS确诊后用多西环素、莫西沙星、奥玛环素、甲强龙治疗。结论：鹦鹉热衣原体肺炎常呈现出高热伴沿肺段分布斑片渗出实变影，白细胞正常，CRP明显升高但PCT正常或轻度增高。具有以上特征的患者，行支气管镜检查，送肺泡灌洗液行mNGS检测查明病原体，多西环素联合糖皮质激素治疗可减短疾病的病程，改善预后。
Keywords
鹦鹉热；衣原体；肺炎；宏基因组二代测序；肺泡灌洗液
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[8] Branley JM, Weston KM, England J, et al. Clinical features of endemic community-acquired psittacosis[J]. New Microbes New Infect, 2014, 2(1): 7-12.
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[15] Nieuwenhuizen AA, Dijkstra F, Notermans DW, et al. Laboratory methods for case finding in human psittacosis outbreaks: a systematic review[J]. BMC Infect Dis, 2018, 18(1):442.
[16] 陈蓉,陈虹,周敏,等.二代测序诊断鹦鹉热衣原体血流感染二例[J]. 中华结核和呼吸杂志,2020,43(9):796-798.
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