肺弥漫出血型钩端螺旋体病的早期诊断

Early diagnosis of leptospirosis with diffuse pulmonary bleeding

目的 探讨肺弥漫出血型钩端螺旋体病 (钩体病 )的临床及影像学特征。方法 回顾性分析肺弥漫出血型钩体病的流行病学、临床表现、影像学特征、实验室检查及治疗结果。结果 肺弥漫出血型钩体病的发病率较高 ,占同期钩体病 38% ,青壮年农民为主 ;所有病人均有发热和咯血 ;其胸片及胸部CT较早出现二肺弥漫点片及大片状密度增高的模糊阴影 ,且与病情轻重基本一致 ,治疗后消失较快。结论 肺弥漫出血型钩体病是本地新出现的钩体病临床类型 ,胸片及CT检查早期出现异常阴影可提供肺出血钩体病的诊断线索 ,且对判断病情及预后有重要价值。

Objective To explore the early diagnostic value of chest X ray film and chest CT menifestations on leptospirosis with diffuse pulmonary bleeding.Methods Ten cases of leptospirosis with diffuse pulmonary bleeding were retrospectively analyzed including epidemiology,clinical menifestations,imageological characteristics,experiment examine and treatments.Results Leptospirosis with diffuse pulmonary bleeding had higher morbidity,38% cases of the leptospirosis were complicated with diffuse pulmonary bleeding in the same period.Most patients were young and adults peasants.All patients suffered from fever and hemoptysis,diffuse spots and a large flake shadows early showed at chest film,comsisted with the severity of the disease.Conclusion Diffuse spots and large flake shadows showed at chest film may provide diagnostic clue on leptospirosis with diffuse pulmonary bleeding,which is a new clinical type of leptospirosis in this area.