沙眼衣原体肺部感染的临床特点

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目的 研究沙眼衣原体 (CT)肺部感染的临床特点和诊疗措施。方法 应用聚合酶链反应 (PCR)检测 2 99例住院肺炎患儿呼吸道分泌物中的CT DNA ,其中 62例同时测定血CT IgM。 结果 CT肺炎占同期小儿肺炎的 1 0 .4 % ,1~ 6个月的小婴儿CT肺炎的检出率为 1 4 .8% ,高于 >6个月龄组 6 .7% (χ2 =5 .2 4 P<0 .0 2 5) ;1~ 6个月的无热肺炎中CT肺炎占 2 4 % ,高于有热肺炎组 8.6 % (χ2 =6 .1 1 P <0 .0 2 5)。CT肺炎病程 1 0~ 1 0 1d ,71 %可闻及湿罗音 ,38.7%有哮鸣音 ,45 %白细胞增高 ,X线主要呈支气管肺炎改变。以CT PCR为标准 ,CT IgM阳性一致率 71 .4 % ,阴性一致率 67.3 %。红霉素有效率 85 .7% ,凯福隆为 80 %。结论 CT肺炎多见于小婴儿无热肺炎 ,病程较迁延 ,其他表现缺乏特异性 ,CT IgM诊断CT肺炎特异性不高 ,治疗除红霉素外凯福隆不失为一种选择 Objective To study the clinical characteristics and diagnosis and treatment of pulmonary infection of Chlamydia trachomatis (CT). Methods PCR DNA was used to detect CT DNA in respiratory secretions of 299 children with hospitalized pneumonia, and 62 of them were tested for serum CT IgM at the same time. Results CT pneumonia accounted for 10.4% of children with pneumonia in the same period. The detection rate of CT pneumonia in infants younger than 1-6 months was 14.8%, which was higher than that of 6-month-old children (6.7%, χ2 = 5.22 P <0.025). CT pneumonia was 24% in non-febrile pneumonia in 1 to 6 months and 8.6% in thermophilic pneumonia group (χ2 = 6.11 P <0.0 2 5). The duration of CT pneumonia was between 100 and 110 days, with 71% of measles and wet rales, 38.7% of patients with wheeze, and 45% of leukocytosis. The X-ray showed bronchopneumonia. Using CT PCR as the standard, CT IgM positive consistency rate of 71.4%, negative consistency rate of 67.3%. Erythromycin 85.5% efficiency, Kefalon 80%. Conclusion CT pneumonia is more common in infants with no fever pneumonia, the duration of the disease is more delayed, the other manifestations of the lack of specificity, CT IgM diagnosis of CT pneumonia is not specific, the treatment of erythromycin outside the Kefu Fulong is an option
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