Chlamydia pneumoniae replicates in Kupffer cells in mouse model of liver infection

AIM: To develop an animal model of liver infection with Chlamydia pneumoniae (C. pneumoniae) in intraperito-neally infected mice for studying the presence of chlamy-diae in Kupffer cells and hepatocytes.METHODS: A total of 80 BALB/c mice were inoculated intraperitoneally with C. pneumoniae and sacrificed at various time points after infection. Chlamydiae were looked for in liver homogenates as well as in Kupffer cells and hepatocytes separated by liver perfusion with collagenase. C. pneumoniae was detected by both isola-tion in LLC-MK2 cells and fluorescence in situ hybridiza-tion (FISH). The releasing of TNFA-α by C. pneumoniae in vitro stimulated Kupffer cells was studied by enzyme-linked immunosorbent assay.RESULTS: C. pneumoniae isolation from liver homoge-nates reached a plateau on d 7 after infection when 6 of 10 animals were positive, then decreased, and became negative by d 20. C. pneumoniae isolation from sepa-rated Kupffer cells reached a plateau on d 7 when 5 of 10 animals were positive, and became negative by d 20. The detection of C. pneumoniae in separated Kupffer cells by FISH, confirmed the results obtained by culture. Isolated hepatocytes were always negative. Stimula-tion of Kupffer cells by alive C. pneumoniae elicited high TNF-α levels. CONCLUSION: A productive infection by C. pneumo-niae may take place in Kupffer cells and C. pneumoniae induces a local pro-inflammatory activity. C. pneumoniae is therefore, able to act as antigenic stimulus when local-ized in the liver. One could speculate that C. pneumoniaeinfection, involving cells of the innate immunity such as Kupffer cells, could also trigger pathological immune re-actions involving the liver, as observed in human patients with primary biliary cirrhosis.

Relationship between Chlamydia pneumoniae infection and occurrence of bronchial asthma

Objective: To study the relationship between Chlamydia pneumoniae (C. pneumoniae) infection and asthma exacerbation. Methods: A prospective study of C. pneumoniae infection was conducted in 75 patients with asthma and 63 patients with respiratory tract infection, and 100 blood donors served as controls. The presence of infection was convinced by the polymerase chain reaction and direct immunofluorescence assay for C. pneumoniae DNA from throat swab specimens and micro-immunofluorescence testing for C. pneu-moniae-specific IgG, IgM and IgA antibodies. Results: Prevalence of specific IgG in asthma patients (81. 3%) was higher than that of the blood donors (68. 0%, P<0. 05) and was not significantly different from respiratory tract infection patients (68. 0%, P>0. 05). The acute C. pneumoniae infection rate of symptomatic asthma patients (59. 4%) was markedly higher than that of respiratory tract infection patients (34. 9% , P<0. 05). The average titer of C. pneumoniae IgG instead of IgA in asthma patients (48. 38±6. 94) was significantly higher than respiratory tract infection patients (24. 70±8. 77, P<0. 05). Other pathogens were identified in 12 of 21 (57. 1%) asthma patients with C. pneumoniae. The symptoms of 7 asthma patients with C. pneumoniae infection were improved through antibiotic treatment. Conclusion: The findings suggest a possible role of C. pneumoniae infection in asthma.

The Study of Chlamydia Pneumoniae DNA in the Peripheral Blood Mononuclear Cell of Coronary Heart Disease

Objectives To detection of chlamydia pneumoniae (Cpn) DNA in the circulating mononuclear cell fractions of coronary heart disease and to investigate the association between infection with chlamydia pneumoniae and coronary heart disease (CHD) and prospectively whether blood - based nes- ted polymerase chain reaction(nPCR ) is useful in i- dentifying Cpn infection. Methods The peripheral blood mononuclear cell (PBMC) Cpn DNA was exam- ined using nPCR technique and confirmed by electro- phoresis in 150 patients with CHD. Select 55 patients with clinical suspected CHD but angiography result are normal as control group (CG). Then we conducted a prospective , randomized, double - blind, placebo - controlled study of 6 months of azithromycin and place- bo treatment in CHD group. Patients with Cpn DNA positive were then randomized to receive azithromycin or placebo. After treatment blood sample were collect- ed for repeated measurement . Results Chlamydia pneumoniae DNA was detected in 49(32. 7% ) of 150 persons with CHD and in 1 (1. 8% ) of 55 persons with control group,odds ratio 26. 2, 95% confidence interva 13. 52 - 194. 98. The positivity rates of nPCR in CHD groups were higher than those in control group. 16 ca- ses (29. 1%) in latent coronary heart diseases (LCHD)group , 19 cases (39.6%) in unstable angi- na(UAP) group ,and 14 cases (29.9% ) in acute my- ocardial infarction (AMI) group were Cpn positive by nPCR. There were no significant difference among in AMI^UAP and LCHD group. There were significiantdifference in Cpn DNA negative rates after the azithro- mycin and the placebo treatment. Conclusions Chlamydia pneumoniae is present in PBMC of a signifi- cant proportion of persons with CHD. The potential role of chlamydia pneumoniae in coronary atherosclerosis may therefore be more related to acceleration of disease or systemic effects by persistent infection than to sud- den initiation of progressive coronary artery disease by acute infection. The detection of Cpn DNA in PBMC with nPCR may be of great value for identifying Cpn carriers and for monitoring antichlamydial therapy.

Analysis of the effect of Chlamydia pneumoniae on the lipid metabolism of mononuclear macrophages in patients with carotid atherosclerotic plaque

Objective:To explore the effect of Chlamydia pneumoniae on the lipid metabolism of mononuclear macrophages in patients with carotid atherosclerotic plaque.Methods: A total of 90 patients with carotid atherosclerosis who were admitted in our hospital from January, 2012 to December, 2013 were included in the study and served as the observation group, while 72 aged individuals at the same stage for physical examination were served as the control group. The plaque formation in the two groups was observed and compared. The levels of TC, LDL-C, and HDL-C in the two groups were detected and compared. ELISA was used to detect CP IgG. The positive rate of CP IgG in the two groups was compared.Results: The multiple plaque, soft plaque, and mixed plaque in the observation group were significantly greater than those in the control group, but the comparison of hard plaque between the two groups was not statistically significant. The levels of TC and LDL-C in the observation group were significantly higher than those in the control group, while HDL-C level was significantly lower than that in the control group. The positive rate of CP IgG in the observation group was significantly higher than that in the control group.Conclusions: Chlamydia pneumoniae has an important effect on the lipid metabolism of mononuclear macrophages in patients with carotid atherosclerotic plaque.

The Role of Chlamydia pneumoniae in the Atherosclerotic Process of Patients under 50 Years of Age Who Underwent Coronary Artery Bypass Graft Surgery

Background: To evaluate the presence of C. pneumoniae DNA in the tissues and C. pneumoniae DNA antibodies in the blood samples of patients who underwent CABG surgery. Material and Methods: Fifty-one patients aorta. C. pneumoniae DNA was evaluated in the tissues collected from the atrium, left internal thoracic artery and ascending aorta of patients. Results: Although, C. pneumoniae DNA was negative in the atrial and left internal thoracic artery tissues of all patients, it was positive in the tissues obtained from the ascending aortas of twelve patients. C. pneumoniae DNA positivity was significantly higher in patients with increased aortic intimal thickness compared to those without increased aortic thickness. Conclusion: The question whether C. pneumoniae is triggering atherosclerosis or is involved as a super-infection could not be clarified.

流产衣原体非典型重症肺炎的诊断及临床特点

目的 探讨流产衣原体非典型重症肺炎的诊断及临床特点。方法 收集2021年1月—2022年11月某院收治并诊断为流产衣原体非典型重症肺炎4例患者的临床资料,全面分析该疾病的临床特征、诊治要点及注意事项。结果 4例患者均为男性,年龄63~73岁,急性起病,均表现为高热、咳嗽、咳痰;3例患者有家禽接触史,1例有流产山羊接触史。4例患者从有临床症状到出现急性呼吸衰竭的间隔时长为1~6 d,且入院时氧合指数(PaO_(2)/FiO_(2))均<200 mmHg,随病情发展呈进行性下降,需积极呼吸机支持。2例患者白细胞计数升高,4例中性粒细胞百分比升高,3例血小板计数轻度降低;4例患者中2例患者天冬氨酸转氨酶升高,2例患者丙氨酸转氨酶升高,3例患者肌酸激酶升高,4例患者血清肌酐均升高,2例轻度低钠血症;4例C反应蛋白、降钙素原、白介素-6明显升高。4例患者胸部CT表现以单个或多个肺叶累及为主,渗出实变,后期累及多个肺叶。支气管肺泡灌洗液宏基因组二代测序均检测出流产衣原体DNA序列。结合4例患者的临床表现、接触史、胸部CT、宏基因组二代测序等结果,诊断为流产衣原体非典型重症肺炎,通过及时调整以多西环素为基础的抗感染治疗方案后,患者病情好转出院。结论 流产衣原体也可能导致人类肺炎发生,感染后可导致严重临床后果,当患者有动物接触史时,需警惕此类疾病;宏基因组二代测序可以检出流产衣原体。

鹦鹉热衣原体肺炎的胸部CT影像表现

目的:探讨鹦鹉热衣原体肺炎的胸部CT影像表现。方法:回顾性分析22例鹦鹉热衣原体肺炎患者的临床及胸部CT资料,分析肺内病变的影像学特点及肺外影像表现。结果:22例鹦鹉热衣原体肺炎中,15例肺内病变表现为大叶性肺炎,5例表现为斑片结节,2例表现为支气管肺炎,常见伴随征象包括:小叶间隔增厚(12例)、小叶内网状影(11例)、铺路石征(6例),少数可见晕征(3例)、反晕征(1例)、小叶中心性结节(1例)、支气管壁增厚(2例)、支气管牵引性扩张(1例)。所有病变均未见坏死或空洞。肺内病变分布:累及单肺19例,双肺3例;累及上肺区6例,下肺区13例,上、下肺区同时受累3例;外周分布12例,支气管血管周围分布4例,弥漫分布6例。10例合并胸腔积液,3例伴纵隔淋巴结增大。结论:鹦鹉热衣原体肺炎的影像表现以大叶性肺炎最多见,典型者表现为斑片状实变伴空气支气管征,多合并磨玻璃密度影,常伴小叶间隔增厚、小叶内网状影及铺路石征等间质受累表现,可见胸腔积液、纵隔淋巴结增大。

鹦鹉热衣原体肺炎的CT表现特征

目的探讨鹦鹉热衣原体肺炎患者的CT表现特征。方法回顾性分析笔者医院经宏基因二代测序(macrogene second-generation sequencing,m NGS)技术确诊10例鹦鹉热衣原体肺炎患者的胸部CT图像。结果7例(70%)患者与鸟(禽)类或其粪便有接触史。入院胸部CT均表现为团片状渗出实变影,均位于单肺,其中累及单叶8例(80%)、双叶2例(20%);10例(100%)均伴有支气管充气征,9例(90%)有磨玻璃影,8例(80%)局部小叶间隔或小叶内间隔增厚;1例(10%)病灶呈“扇形”改变,1例(10%)病灶见“反晕症”,9d内复查9例(90%)有进展,表现为病灶融合增大呈更大范围实变或新出现病灶。结论鹦鹉热衣原体肺炎CT表现具有一定特征,结合鸟(禽)类接触史可提示诊断。

冠心病经皮冠状动脉介入术治疗前后患者血清肺炎衣原体抗体IgA、超敏C-反应蛋白、血管生成素-2变化及预后预测价值研究

目的:探讨冠心病(CHD)经皮冠状动脉介入术治疗前后患者血清肺炎衣原体抗体IgA(CP-IgA)、超敏C-反应蛋白(hs-CRP)及血管生成素-2(Ang-2)变化及预后预测价值。方法:选取CHD患者135例为观察组,根据患者预后情况分为预后良好组(119例)及预后不良组(16例)。另选取同期体检健康者135例为对照组。比较观察组和对照组、观察组PCI前后以及两个亚组血清CP-IgA、hs-CRP及Ang-2水平。分析血清CP-IgA、hs-CRP及Ang-2与PCI术后CHD患者预后的相关性。分析血清CP-IgA、 hs-CRP及Ang-2对PCI术后CHD患者预后的预测价值。结果:观察组血清CP-IgA、hs-CRP及Ang-2水平高于对照组(均P<0.05)。观察组患者PCI术后血清CP-IgA及Ang-2水平较PCI术前降低,血清hs-CRP水平较PCI术前升高(均P<0.05)。预后良好组患者血清CP-IgA、hs-CRP及Ang-2水平低于预后不良组(均P<0.05)。血清CP-IgA、hs-CRP及Ang-2与PCI术后CHD患者预后呈正相关(均P<0.05)。血清CP-IgA、hs-CRP及Ang-2单独预测PCI术后CHD患者预后的曲线下面积(AUC)小于三项联合(均P<0.05)。结论:CHD患者血清CP-IgA、hs-CRP及Ang-2水平升高,PCI术后血清CP-IgA和Ang-2水平降低,hs-CRP水平升高。预后不良患者血清CP-IgA、hs-CRP及Ang-2水平升高,且三者联合对PCI术后CHD患者预后的预测价值较高。

鹦鹉热衣原体肺炎临床特征分析

目的综合分析25例确诊为社区获得性鹦鹉热衣原体肺炎患者的临床特征及诊治过程,为高效诊治鹦鹉热,降低并发症,提高重症患者的生存率提供科学依据。方法回顾性分析2020年9月至2023年2月由我院收治的25例鹦鹉热衣原体肺炎患者的临床资料,总结鹦鹉热衣原体肺炎的临床特征及诊治要点。结果25例患者,其中男性15例,女性10例,中位数年龄为69岁(41~80岁),主要临床表现为高热、咳嗽、气喘、乏力,均有鸟类或家禽类接触史,从起病到就诊时间为4 d(1~10 d)。患者白细胞基本正常,常规CRP、降钙素原(PCT)明显升高。15例患者进行细胞免疫检查,其中13例CD4、CD8细胞数量降低。气管镜检查主要表现为气道黏膜充血水肿,气道中痰液较少。患者存在低氧血症,严重者出现呼吸衰竭,医师对患者经验性使用抗菌药物治疗效果不佳。利用宏基因组二代测序(mNGS)技术及时调整以四环素类药物为基础的治疗方案后病情好转,缩短了鹦鹉热衣原体肺炎的诊断时间和病程。结论有鸟类或家禽类接触史的社区获得性肺炎患者,利用mNGS可提高鹦鹉热衣原体肺炎诊断的准确性,尽早启动以四环素为基础的治疗方案治疗效果显著,但仍需警惕在病程中继发细菌感染及其他并发症的风险。

肺炎衣原体CPn0308的基因克隆及其内源性蛋白定位的研究

目的克隆肺炎衣原体基因CPn0308,表达融合蛋白,并制备抗体对其表达的内源性蛋白进行初步定位。方法根据STD基因库提供的信息设计引物,聚合酶链反应(PCR)克隆目的基因,用BamHI/NotI对克隆的目的基因和pGEX-6P2载体进行酶切,T4连接酶连接后,重组质粒经42℃转化XL1-blue细菌;用PCR进行初步筛选,交叉PCR对提取质粒进一步确定,最后对插入片断进行序列分析;用IPTG诱导阳性克隆的细菌使其表达GST融合蛋白,纯化后免疫小鼠制备抗体,使用IFA对内源性蛋白进行定位分析。结果克隆出肺炎衣原体基因CPn0308,全长为366bp,编码121个氨基酸;并表达了融合蛋白GST-CPn0308,分子量约为39kD;制备了抗体,IFA实验发现该蛋白初步定位于肺炎衣原体包涵体膜蛋白上。结论成功克隆肺炎衣原体基因CPn0308,其内源性蛋白初步定位于肺炎衣原体包涵体膜上。

1例鹦鹉热衣原体重症肺炎患者的抗感染治疗及药学监护

目的为鹦鹉热衣原体重症肺炎的抗感染药物治疗及药学监护提供思路和用药参考。方法临床药师参与1例鹦鹉热衣原体重症肺炎患者治疗的全过程,根据患者病史、临床症状、检验结果等情况,协助临床医师动态调整抗感染药物治疗方案:针对鹦鹉热衣原体感染,给予患者替加环素联合阿奇霉素治疗,并结合病原体检查结果对治疗其他感染的用药方案进行动态调整。在治疗过程中,患者出现了QTc间期延长和脂肪酶、淀粉酶升高的可疑药物不良反应,临床药师进行了药学监护并提出合理建议。结果临床医师采纳临床药师建议,患者经治疗后好转出院。结论治疗鹦鹉热衣原体重症肺炎,应兼顾患者、药物、病原体三者的特点个性化制定抗感染药物治疗方案。四环素类抗生素和大环内酯类抗生素对鹦鹉热衣原体感染有明确疗效,但是在临床应用中需关注药物可能引起的不良反应。

7例鹦鹉热衣原体肺炎的临床特征分析

目的分析鹦鹉热衣原体肺炎患者的临床特点及早期诊治方法,旨在提高对该病的认识。方法收集2020年12月至2023年3月清远市人民医院经宏基因组测序(mNGS)诊断的7例鹦鹉热衣原体肺炎的病例,回顾性分析患者的临床表现、实验室检查、影像、病理学特点、mNGS结果和治疗过程等临床资料。结果7例均为男性患者,年龄30~79岁,以高热、头痛、乏力为起病主要表现。7例患者均出现淋巴细胞比率下降,C-反应蛋白升高。6例降钙素原、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、乳酸脱氢酶和直接胆红素明显升高,且凝血功能异常。7例患者胸部CT主要表现为斑片状密度增高影,部分实变,且均可见支气管充气影,4例伴胸腔积液,2例胸膜增厚。其中5例患者行经支气管镜刷检物细胞学检测,病理学表现无特异性,均为炎性细胞浸润。所有患者行mNGS检测,均检出鹦鹉热衣原体核酸序列,确诊后针对性选择多西环素联合其他抗感染药物,病人好转出院。结论鹦鹉热衣原体肺炎发病率低,诊断困难,mNGS是早期诊断的重要检测技术,有助于及时启动针对性抗感染治疗,改善预后。

黄芩苷对CPn感染高胆固醇饮食小鼠血清TNF-α、IL-6、IL-10的调节作用

目的:探讨肺炎衣原体感染高胆固醇饮食小鼠后血清TNF-α、IL-6、IL-10水平的变化及黄芩苷的治疗作用。方法:小鼠随机分为黄芩苷高剂量组、黄芩苷低剂量组、阿奇霉素组、高胆固醇+CPn感染组、正常对照组。喂饲高胆固醇饲料1周后,经一侧鼻腔吸入含CPn的培养液,每周1次,共3次。最后一次接种5天后开始给药至实验结束,第1次接种后第18周处死全部动物。结果:高胆固醇+CPn感染组血清TNF-α、IL-6、IL-10水平不同程度升高,三个治疗组三种炎症因子水平不同程度下降。结论:CPn感染可使高脂饮食C57BL/6J小鼠血清TNF-α、IL-6、IL-10水平升高,早期给予高、低剂量黄芩苷或阿奇霉素治疗可不同程度地调节这三种炎症因子的水平。

四川地区24例鹦鹉热衣原体肺炎的临床特点及治疗分析

目的分析四川地区鹦鹉热衣原体肺炎患者的临床特征及治疗方案,为临床诊治提供参考。方法对成都市第二人民医院2020年12月至2023年2月收治的通过宏基因二代测序(mNGS)确诊的24例鹦鹉热衣原体肺炎患者进行回顾性分析。结果患者主要以发热为首要表现,其他临床症状包括畏寒、寒战、头晕、头痛、乏力、咳嗽、咳痰、肌肉酸痛等,主要并发症为急性呼吸衰竭和肝功能不全,胸部CT多呈单侧肺叶炎性改变,一半以上患者出现胸腔积液。采用多西环素、氟喹诺酮类单药或联合用药的方案进行抗感染治疗后预后良好,联合用药在退热时间上优于单药治疗,但是不能缩短住院时间和用药疗程。结论鹦鹉热衣原体肺炎患者多有鸟类接触史。对不明原因社区获得性肺炎患者应仔细询问其流行病学史,同时结合患者的临床表现、实验室检查和影像学检查对疑似鹦鹉热的患者尽早通过mNGS技术进行辅助诊断。多西环素和氟喹诺酮类药物在鹦鹉热衣原体肺炎患者的治疗中有效,联合用药能使患者体温更快恢复正常。

肺炎嗜衣原体Cpn0147重组蛋白的免疫学活性研究

目的研究Cpn0147重组蛋白的免疫学活性及其应用于肺炎嗜衣原体(Cpn)感染临床诊断中的价值。方法采用GST琼脂糖凝胶纯化目的蛋白,将Cpn0147重组蛋白免疫新西兰兔,分别应用Westernblot、ELISA法检测其免疫反应性及免疫原性,同时通过检测临床标本以评估其诊断价值。结果成功表达并纯化了相对分子质量约41×103的重组蛋白GST-Cpn0147;Westernblot和ELISA结果显示,该重组蛋白具有良好的免疫反应性,动物实验结果表明该重组蛋白具有较好的免疫原性,ELISA结果显示该重组蛋白免疫新西兰兔血清抗体效价为1:12800。结论 Cpn0147重组蛋白具有较好免疫学活性和特异性,可为Cpn感染的确诊、预防研究奠定基础。

三重TaqMan qPCR检测呼吸道感染衣原体方法的建立及应用

目的本试验的目的是建立可以快速鉴别诊断呼吸道感染肺炎衣原体(Cpn)、鹦鹉热衣原体(Cps)和沙眼衣原体(Ct)的三重TaqMan qPCR方法,有助于衣原体病的科学防控和指导临床用药,为公共卫生安全提供保障。方法选择Cpn、Cps和Ct特异基因ARGR、ompA和ORF8设计引物,建立标准曲线,优化反应条件和体系,验证方法的灵敏度、重复性;通过单独检测3种衣原体的荧光定量PCR方法验证本研究建立方法的准确性。结果结果显示,所建立的三重TaqMan qPCR方法特异度和重复性好,检测灵敏度分别为45 copy/μL(Cpn)、40 copy/μL(Cps)和43 copy/μL(Ct);利用该方法对600个临床样本进行检测,其检出率与参考方法比较,差异无统计学意义(P>0.05),表明该方法检测结果可靠。结论本研究建立的检测呼吸道感染衣原体的三重TaqMan qPCR方法特异性和重复性好,灵敏度高,结果可靠,为呼吸道感染衣原体临床诊治和流行病学监控提供有力工具。

重症鹦鹉热衣原体肺炎1例

鹦鹉热衣原体肺炎是一种较为少见的人畜共患病,肺部病变重,多合并急性呼吸衰竭及多器官功能受损,因缺乏特发性,常被误诊或漏诊。该文对1例鹦鹉热衣原体肺炎的诊疗进行报道。

Cpn0308真核表达载体的构建及对小鼠免疫功能的影响

目的:构建Cpn0308重组质粒pcDNA3.1/His A-Cpn0308,将重组质粒腹腔注射小鼠后观察小鼠免疫反应变化,以期为进一步研究Cpn0308免疫保护性奠定基础。方法:构建pcDNA3.1/His A-Cpn0308,并用菌落PCR、双酶切、序列测定等多种技术确定其正确性;将重组质粒转染HeLa细胞,间接免疫荧光法检测细胞内蛋白表达情况;重组质粒免疫BALB/c小鼠,一定时间后Western blot检测血清Cpn0308抗体特异性,间接ELISA法检测小鼠血清中Cpn0308 IgG抗体水平、ELISA试剂盒检测血清中细胞因子。结果:pcDNA3.1/His A-Cpn0308重组质粒构建成功且序列正确;重组质粒转染的HeLa细胞胞浆观察到黄绿色荧光,对照组无荧光;重组质粒组血清抗体A450x±s为0.343±0.024,pcDNA3.1/His A质粒组为0.174±0.018,PBS组为0.156±0.023,WB结果显示重组质粒组小鼠血清稀释800倍后仍有特异性目的条带出现,对照组不出现;重组质粒组小鼠IFN-γ浓度均值为264 ng/L,IL-4浓度均值为22 ng/L,pcDNA3.1/His A质粒组为:IFN-γ120 ng/L,IL-4 10 ng/L,PBS组为:IFN-γ99 ng/L,IL-4 9 ng/L。重组质粒组IgG抗体水平和细胞因子水平明显升高,与对照组相比有统计学差异。结论:pcDNA3.1/His A-Cpn0308真核表达重组质粒构建成功,且能够在真核细胞中表达目的蛋白;重组质粒对小鼠进行免疫后,提高了小鼠血清IgG抗体水平和细胞因子水平,为进一步研究Cpn DNA疫苗以及研究该蛋白的生物学功能提供实验基础。

51例社区获得性鹦鹉热衣原体肺炎的临床影像学与疗效分析

目的探讨鹦鹉热衣原体肺炎的临床影像学特点,从而指导早期诊断及治疗,改善预后。方法回顾性分析我院2019年1月至2023年4月间通过宏基因组二代测序诊断的51例鹦鹉热衣原体肺炎住院患者资料。结果51例患者主要症状为高热(47/51,92.16%)、咳嗽(35/51,68.63%)、咳痰(24/51,47.06%)、胸闷(18/51,35.29%)、呼吸衰竭(17/51,33.33%)。外周血中白细胞正常或减低(38/51,74.50%)、CRP升高(51/51,100%)、转氨酶升高(34/51,66.67%)、D-二聚体增高(48/51,94.12%)。影像学主要表现为:肺实变(46/51,90.20%)、磨玻璃样改变(15/51,29.41%)、胸腔积液(23/51,45.10%)、多叶病变(13/51,25.50%)。治疗:单药治疗(四环素类、喹诺酮类或大环内酯类)27例(52.94%),总有效率为88.89%;联合治疗(喹诺酮类联合四环素类或大环内酯类)22例(43.14%),总有效率90.90%。结论鹦鹉热衣原体肺炎以高热、咳嗽伴肺实变、磨玻璃样改变为特点,应尽早诊断加用针对性抗生素治疗,重症患者建议早期联合治疗。