不明原因非典型肺炎局部暴發(fā)流行26例

作者：劉文成,王宗燁,鄭成中,苗寧,敬華,李潔,楊戈,姜玉峰,顧穎
【關(guān)鍵詞】 非典型肺炎；傳染；流行病學
　　Local epidemic of atypical pneumonia with unknown cause: A clinical analysis of 26 cases
　　【Abstract】 AIM: To investigate the epidemiological characteristics and clinical manifestations of atypical pneumonia with unknown cause. METHODS: Clinical data were retrospectively analyzed in 26 cases of atypical pneumonia with unknown cause. RESULTS: A group of 26 patients (18 males and 8 females, average age: 22.5 years) were admitted in the hospital. The patients worked at the same institution and resided in the same building. The main symptom was fever, with less or no infectiontoxic manifestations and respiratory symptoms. All the Xray examinations showed multiple or solitary dotmassive shadows with high or inconsistent density, and the edge of the shadows was not clear. Laboratory assays demonstrated that the number of leukocytes was decreased or normal, and monocytes were increased. All the antibodies to known pathogenies were negative. The patients were isolated during the treatment, in which 16 patients were treated with antibiotics and antivirus, 8 patients with antivirus only. The body temperature became normal in all the patients after 5day treatment, without respiratory failure and death. CONCLUSION: The basic features of the patients are in accord with those of atypical pneumonia with high infectiosity. Respiratory spread is the main route of transmission. The disease occurs in an aggregated population with an incubation period of 0.5-6 d and with slight symptoms and a tendency of spontaneous cure. Pulmonary shadows appear quickly after onset of the disease.
　　【Keywords】 atypical pneumonia; infectiosity; epidermiology
　　【摘要】 目的：探討不明原因非典型肺炎患者的流行病學特征和臨床表現(xiàn). 方法：對26例集中發(fā)病的不明原因非典型肺炎患者的臨床資料進行回顧性研究分析. 結(jié)果： 觀察對象中男性18例，女性8例，平均年齡22.5歲，均為同一單位，同一大樓集體居住. 主要癥狀為發(fā)熱、感染中毒癥狀，呼吸道癥狀輕或缺如. 肺部X線片均表現(xiàn)為多發(fā)或單發(fā)的點片狀密度增高影，密度不均，邊緣不清. 外周血白細胞總數(shù)正�；蚪档�；單核細胞百分比升高；引起非典型肺炎的常見已知的病原體抗體檢測均陰性，全部住院隔離治療；應(yīng)用甲磺酸培氟沙星/環(huán)丙沙星 利巴韋林治療16例，單純抗病毒治療8例. 26例入院5 d體溫恢復(fù)正常. 無呼吸衰竭及死亡病例. 結(jié)論：本病基本特征符合非典型肺炎特點且具有較強傳染性，呼吸道為主要傳播途徑；發(fā)病呈人群聚集性，發(fā)病后迅速出現(xiàn)肺部片影；潛伏期0.5~6 d. 癥狀輕微，有自愈傾向.
　　【關(guān)鍵詞】 非典型肺炎；傳染；流行病學
　　【中圖號】 R563.1
　　0引言
　　由于非典型肺炎、禽流感這些呼吸道傳染病的出現(xiàn)，給人類健康帶來極大威脅，人們對不明原因非典型肺炎更加重視. 某單位聚集性發(fā)生一批臨床表現(xiàn)相同的非典型肺炎小范圍暴發(fā)流行. 8 d內(nèi)共發(fā)病26例，現(xiàn)就此的臨床流行病學特征、臨床診斷、治療及轉(zhuǎn)歸等進行初步分析.
　　1對象和方法
　　1.1對象20040418/20040424某單位集中發(fā)病的非典型肺炎患者26(男18，女8)例，年齡19~27（22±2.2）歲. 僅2例有既往疾病史（1例患魚鱗病，另1例有肺結(jié)核病史）.
　　1.2方法所有病例均進行血液細胞及血沉檢測. 健康對照組采用同期體檢人員30(男20，女10)例，年齡18~29(平均24)歲. 取其靜脈血同時進行實驗

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