单一与多重军团菌感染所致肺炎的临床对比分析

Clinical comparative analysis of pneumonia due to legionellae of single and multiple species/serogroups

目的 探讨单一与多重军团菌感染所致肺炎的临床特点,提高对军团菌肺炎的认识。方法 对10例单一种/型军团菌感染(单一感染组)及7例多种/型军团菌感染(多重感染组)所致肺炎患者的临床资料进行对比分析。结果 军团菌多重感染多见于既往体健的中壮年,单一感染多见于有基础病的老年人。多重感染组呼吸困难、胸腔积液、急性呼吸窘迫综合症(ARDS)发生率高,肺受累范围较大,肺外表现即多系统受累包括多汗、腹泻,肌肉关节痛、电解质紊乱、氮质血症、肝酶及肌酶升高更多见。两组患者均有明显血脂异常。结论 军团菌多重感染组病情重于单一感染组。

Objective To consider the clinical features of pneumonia due to legionellae of single and multiple species/ serogroups to enhance recognization of le-gionella pneumonia. Methods 10 cases with pneumonia due to legionellae of single species/serogroups ( Single Infection Group, SIG) and 7 cases due to multiple species/serogroups ( Multiple Infection Group, MIG) were analyzed comparatively. Results Multiple infection was more often found in middle-aged men in good health while single infection was more often seen in the old with under lying dis- ease. Besides higher incidence of dyspnea, pleural effusion, ARDS, wider pulmonary involvement, the extrapulmonary mani-festitations including hyperhidrosis, diar-rea, myalgia, electrolyte disorders, nitrernia,elevated hepatic enzyme and muscular enzyme were more common in MIG. Obvious abnormality of blood-lipid existed in two groups. Conclusion The degree of illness in MIG showed more serious than that in SIG. Erythromycin and quinolone group of antimicrobial agents showed good therapeutic effects in both groups.