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The clinical data of patients with chlamydia psitsiti pneumonia confirmed by metagenomic next-generation sequencing (mNGS) who were admitted to the Huizhou Municipal Central Hospital from January 2020 to November 2021 were retrospectively analyzed. Among 21 patients, the serum creatine kinase (CK) was elevated in 10 cases, and 5 cases was complicated with rhabdomyolysis (RM). The symptoms of patients with Chlamydia psittaci pneumonia-induced RM were severe, including high fever, dyspnoea, headache and myalgia; 2 case were complicated by acute kidney injury (AKI) and neurological symptoms. Laboratory testing showed a marked increase in CK, myoglobin (Mb), high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and D-dimer levels in all 5 patients. The chest CT revealed large areas of pulmonary consolidation, ground-glass opacity in 1 case and a small amount of pleural effusion in 2 cases. One patient died from multiple organ failure, and the other 4 patients were discharged with considerable improvement. Patients with psittacosis pneumonia are prone to developing rhabdomyolysis, early detection and early treatment can effectively improve the prognosis of patients.
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Objective:To analyze the clinical characteristics of Chlamydia psittaci pneumonia and to investigate the correlation between serum inflammatory biomarkers and severity of the disease. Methods:Sixteen patients with Chlamydia psittaci pneumonia admitted to the Huizhou Municipal Central Hospital from January 2020 to July 2021 were selected as the study subjects, including 10 severe cases and 6 mild cases. Clinical data were collected and analyzed, such as baseline characteristics, clinical symptoms, laboratory inspection and chest imaging manifestations. Results:① Thirteen Chlamydia psittaci pneumonia were associated with a definite bird or poultry contact history. Common symptoms included high fever, chill, cough, fatigue, and anorexia (16 cases), dyspnoea (12 cases), and other systemic symptoms. ② Laboratory test results showed normal white blood cell count (WBC, 10 cases), decreased lymphocyte count (LYM, 13 cases), increased high sensitive C-reactive protein (hs-CRP, 16 cases), D-dimer (15 cases), lactate dehydrogenase (LDH, 13 cases), aspartate aminotransferase (AST, 16 cases) and alanine aminotransferase (ALT, 12 cases) levels, however, the albumin (Alb, 15 cases) lever was decreased. The numbers of CD3 + T cells and CD4 + T cells decreased in 10 patients. ③ The levels of D-dimer, interleukins (IL-2, IL-6, IL-10) in severe Chlamydia psittaci pneumonia were significantly higher than those in mild Chlamydia psittaci pneumonia [D-dimer (μg/L): 10 257±4 203 vs. 1 085±642, IL-2 (ng/L): 1.1 (0.8, 1.7) vs. 0.3 (0.1, 0.7), IL-6 (ng/L): 315 (182, 505) vs. 75 (18, 131), IL-10 (ng/L): 7.0±4.1 vs. 2.3±0.7], but the LYM was lower (×10 9/L: 0.4±0.1 vs. 1.1±0.4), with significant differences (all P < 0.05). ④ Chest imaging manifestations were exudative lesions and large consolidation of lungs. Large consolidation of both lungs can occur in some critically ill patients. Conclusions:Chlamydia psittaci pneumonia is mainly associated with a bird or poultry contact history. The clinical manifestations usually present high fever, dyspnea, normal or slightly increased leucocytes, and lung consolidation. The levels of LYM, D-dimer, IL-2, IL-6 and IL-10 in serum are expected to predict the severity of the Chlamydia psittaci pneumonia.
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Objective To investigate the clinical effect of heart failure recombinant human brain natriuretic peptide (rhBNP) in treatment of chronic pulmonary heart disease (CPHD).Methods Fifty-six CPHD patients with heart failure were randomly divided into control and research group who were hospitalized from January 2010 to December 2011.Patient in two groups were given oxygen,anti-infection,nutritional support and complications treatment.In addition patients in the treatment group was treated with rhBNP.Clinical symptoms,signs and cardiac,pulmonary function of two groups were recorded.Results The pulmonary artery pressure in treatment group were (39.7 ± 6.2) mm Hg and (26.5 ± 3.8) mm Hg before and after treatment,and the difference was significant(t =14.992,P =0.000).The pulmonary artery pressure in control group were (38.4 ±5.1) mm Hg and (31.5 ±4.5) mm Hg before and after treatment,and significant difference were seen (9.378,P =0.000).In addition,pulmonary artery pressure were different between in treatment and control group(t =-9.742,P =0.000).The level of BNP in treatment group was (873.0 ± 12.9) ng/L and (382.0 ± 11.4) ng/L,there was significant difference(t =353.627,P =0.000) ;While in control group,the level of BNP was (862.0 ± 12.3) ng/L and (568.0 ± 12.6) ng/L before and after treatment,and the difference was significant(t =156.135,P =0.000).And there was sinificant difference between the two groups after treatment (t =-103.490,P =0.000).The left ventricular ejection fraction before and after treatment in treatment group was (38 ±9)％ and (65 ±8)％,and the difference was significant(t =-23.056,P =0.000) ;While in control group,the Left ventricular ejection fraction was (32 ± 7) ％ and (47 ± 5) ％ before and after treatment,and the difference was significant (t =-16.485,P =0.000).And the difference between two groups was significant(t =18.308,P ＜ 0.01).24 h urine volume in treatment group was (0.9 ± 0.4) L and (1.6 ± 0.3) L before and after treatment,and the difference was significant(t =-17.320,P =0.000) ;While in control group,24 h urine volume was(0.9 ± 0.2) L and (1.0 ± 0.6) L before and after treatment,and the difference was significant (t =-5.250,P =0.000).And the difference between two groups was significant (t =6.592,P =0.000).The total effective rate in treatment was 82.2％ (23/28),higher than that in the control group (57.1％ (16/28),and the difference was significant(x2 =4.139,P ＜ 0.05).Conclusion rhBNP can improve heart function of CPHD patients with heart failure.