鹦鹉热衣原体肺炎临床特征分析

Clinical characteristics of Chlamydia psittaci pneumonia

目的分析鹦鹉热衣原体肺炎的临床特征,提高临床医生对该疾病的认识及诊治水平。方法回顾性分析2019年12月至2022年9月南昌大学第一附属医院收治的65例鹦鹉热衣原体肺炎患者的临床资料,描述患者的基本资料、临床表现、实验室检查、胸部CT表现、治疗及预后等情况。结果65例患者平均年龄为58岁,多在秋冬季发病,主要表现为发热、咳嗽、乏力等。与非重症患者相比,重症患者淋巴细胞、血小板、白蛋白下降更显著;降钙素原、谷丙转氨酶、谷草转氨酶、乳酸脱氢酶、血肌酐、血尿素氮、D-二聚体升高均更明显。胸部CT多呈磨玻璃影改变,重症患者肺部病变范围较非重症患者更大,且均需要呼吸支持。四环素类及喹诺酮类抗生素治疗有效。结论鹦鹉热衣原体肺炎多发生在秋冬季节,主要表现为高热、咳嗽、多个炎症标志物升高,肺部影像学多呈磨玻璃影改变,重症患者脏器损伤更加明显,经过积极有效的治疗,该疾病预后较好。

This study analyzed the clinical characteristics of Chlamydia psittaci(C.psittaci)pneumonia to improve clinical understanding of the disease,and its diagnosis and treatment.A retrospective analysis was conducted on clinical data from 65 patients diagnosed with C.psittaci pneumonia admitted to the First Affiliated Hospital of Nanchang University between December 2019 and September 2022.The patients’basic data,clinical manifestations,laboratory examination,chest CT findings,treatment,and prognosis were analyzed.The average age of the 65 patients was 58 years,and the incidence was highest in autumn and winter.The main manifestations included fever,cough,and fatigue.Compared with non-severe cases,severe cases showed more significantly lower lymphocytes,platelets,and albumin,but significantly higher procalcitonin,alanine transaminase,aspartate transaminase,lactate dehydrogenase,serum creatinine,blood urea nitrogen,and D-dimer.The chest CT findings showed primarily ground glass shadow changes.The extent of lung lesions in severe cases was greater than that in non-severe cases,and all patients required respiratory support.Tetracycline and quinolone antibiotic treatments were effective.The results suggested that C.psittaci pneumonia occurs primarily in the autumn and winter,and manifests mainly as high fever,cough,and elevation of multiple inflammatory markers.Most of the pulmonary imaging findings showed ground glass shadows.The organ damage was more obvious in more severe cases.After active and effective treatment,the prognosis of the disease is favorable.