广州番禺地区鹦鹉热衣原体肺炎的临床特征及疗效分析

doi:10.20223/j.cnki.1000-8535.2025.11.015

摘要/Abstract

摘要： 目的分析广州番禺地区鹦鹉热衣原体肺炎患者临床表现、实验室及胸部CT特征、并发症以及治疗方案,为其临床诊治提供参考。方法回顾性分析2022年1月—2024年7月在广州市番禺区何贤纪念医院通过二代测序技术确诊的10例鹦鹉热感染患者的临床资料。结果 5例（5/10）患者有明确的鸟类或禽类接触史,8例（8/10）患者以发热为首发症状,发热（10/10）、咳嗽、咳痰（10/10）、呼吸困难（7/10）、相对缓脉（8/10）是主要临床表现。患者白细胞计数通常正常或轻微升高;多数患者存在有不同程度的电解质紊乱（10/10）及肝功能损伤（8/10）、乳酸脱氢酶升高（8/10）,白蛋白显著降低（8/10）和C反应蛋白显著升高（10/10）。最常见的胸部CT异常为多肺叶受累的斑片状或片状实变,而重症患者多合并双侧胸腔积液。大多数患者经四环素或喹诺酮类单用,或者四环素联用β-内酰胺类抗菌药物治疗,预后良好。结论有鸟类或禽类接触史、以发热为首发或主要症状、存在相对缓脉、白细胞计数升高不明显等临床特征可有助于区分鹦鹉热衣原体肺炎与其他传统细菌性肺炎,但这并不能确诊。二代测序技术是确诊鹦鹉热衣原体感染的很好方法,可以缩短诊断延误时间并改善患者预后。

关键词: 鹦鹉热衣原体肺炎, 二代测序技术, 社区获得性肺炎, 临床特征

Abstract: Objective To describe the clinical,laboratory and chest CT characteristics as well as the complications and treatments of Chlamydia psittaci pneumonia patients in Panyu district of Guangzhou,to provide reference for clinical diagnosis and treatment．Methods A retrospective study was conducted on the clinical characteristics of Chlamydia psittaci pneumonia patients who were diagnosed by next-generation sequencing in Panyu Hexian Memorial Hospital of Guangzhou form January 2022 to July 2024． Results Half patients had a definite history of bird or poultry exposure．Fever（100%）,cough,sputum（100%）,dyspnea（70%）,relative bradycardia（80%）were the main clinical presentation．The total white cell counts were usually normal or slightly increased．Most patients had electrolyte disturbance（100%）,liver function impairment（80%）,lactic dehydrogenase increased（80%）,albumin decreased（80%）and C reactive protein increased remarkably（100%）．The most common chest CT abnormality was patchy or flaky hyper densities and consolidation,bilateral pleural effusion was common in severe patients．All patient exhibited good recovery after being treated with tetracycline or quinolone alone,or tetracycline in combination with other antibiotics．Conclusions These characteristics may help distinguish Chlamydia psittaci pneumonia from other traditional bacterial pneumonia,but they are not definitive．Next-generation sequencing may be a promising approach to confirm Chlamydia psittaci infection,which can shorten the diagnostic delay time and improve the prognosis of patients．

Key words: Chlamydia psittaci pneumonia, next-generation sequencing, community-acquired pneumonia, clinical characteristics

李桂华, 吴世权, 梁志华. 广州番禺地区鹦鹉热衣原体肺炎的临床特征及疗效分析[J]. 广州医药, 2025, 56(11): 1574-1580.

LI Guihua, WU Shiquan, LIANG Zhihua. Clinical characteristics and treatment efficacy of Chlamydia psittaci pneumonia in Panyu district of Guangzhou[J]. Guangzhou Medical Journal, 2025, 56(11): 1574-1580.

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