CAJ | 학술논문

目的总结新生儿衣原体肺炎的临床及影像学特点,以提高对该病的认识水平.方法回顾性分析经血清学确诊为新生儿衣原体肺炎的17例患儿的临床及影像学资料.其中男11例、女6例.足月儿16例,过期产儿1例.发病年龄9.0 ～28.0d,平均(16.8±5.8)d.17例均行胸部X线摄片检查；其中13例行CT检查.所有患儿均经间接酶联免疫吸附法检测衣原体IgM及IgG抗体.结果 17例患儿均以无热性呼吸道症状为主要表现,血清学衣原体抗体检查均为阳性.X线胸片表现双侧肺过度通气10例次；广泛小结节及网格影10例次(类粟粒结核改变7例次,实变9例次).CT表现为肺内间质网织结节影13例次,结节影大小、密度及分布不甚均匀,以胸膜下结节影(11例次)及融合结节(10例次)多见；两肺过度充气10例次,合并实质浸润12例次,支气管血管束增厚10例次,磨玻璃影5例次,无胸膜渗出及纵隔淋巴结肿大.结论新生儿衣原体肺炎影像以双肺过度充气和弥漫网织颗粒影为主要表现.临床主要表现为无热性呼吸道感染症状.临床和影像学结合可以高度提示新生儿衣原体肺炎的诊断.
목적 총결신생인의원체폐염적림상급영상학특점,이제고대해병적인식수평.방법 회고성분석경혈청학학진위신생인의원체폐염적17례환인적림상급영상학자료.기중남11례、녀6례.족월인16례,과기산인1례.발병년령9.0 ～28.0d,평균(16.8±5.8)d.17례균행흉부X선섭편검사；기중13례행CT검사.소유환인균경간접매련면역흡부법검측의원체IgM급IgG항체.결과 17례환인균이무열성호흡도증상위주요표현,혈청학의원체항체검사균위양성.X선흉편표현쌍측폐과도통기10례차；엄범소결절급망격영10례차(류속립결핵개변7례차,실변9례차).CT표현위폐내간질망직결절영13례차,결절영대소、밀도급분포불심균균,이흉막하결절영(11례차)급융합결절(10례차)다견；량폐과도충기10례차,합병실질침윤12례차,지기관혈관속증후10례차,마파리영5례차,무흉막삼출급종격림파결종대.결론 신생인의원체폐염영상이쌍폐과도충기화미만망직과립영위주요표현.림상주요표현위무열성호흡도감염증상.림상화영상학결합가이고도제시신생인의원체폐염적진단.
Objective To study the clinical and imaging features of chlamydial pneumonia in newborns.Methods Medical records,chest X-Ray and CT findings of 17 neonates with chlamydia pneumonia were reviewed.The age was ranged from 9.0 to 28.0 days with mean of ( 16.8 ± 5.8 ) days.There were 11males and 6 females.Sixteen were full term infants and one was born post term.All babies were examined with chest X-ray film,and 13 patients also underwent chest CT scan.Serologic test using immunofluorescence method for Chlamydia IgG and IgM antibodies were performed in all patients.Results All newborns presented with cough but without fever.Positive results of the serologic tests were demonstrated.Chest films showed bilateral hyperventilation in 10 patients,diffuse reticular nodules in 10 patients including nodules mimicking military tuberculosis in 7 patients,and accompanying consolidation in 9 patients.CT features included interstitial reticular nodules in 13 patients with size,density,and distribution varied.Subpleurul nodules ( 11patients) and fusion of nodules ( 10 patients ) predominated.Bilateral hyperinflation was found in 10 patients,which combined with infiltration in 12 patients,thickening of bronchovascular bundles in 10 patients,and ground glass sign in 5 patients.No pleural effusion and lymphadenopathy was detected in any patient.Conclusions Bilateral hyperinflation and diffuse interstitial reticular nodules were the most common imaging features of neonatal chlamydial pneumonia.The main clinical characteristic of neonatal chlamydial pneumonia is respiratory symptoms without fever,which is helpful to its diagnosis.