摘要
目的提高对非免疫缺陷病毒(HIV)感染者罹患肺孢子菌肺炎的认识。方法回顾性分析2009—2011年7例非HIV感染的免疫抑制患者发生肺孢子菌肺炎的临床资料。结果 7例均为长期服用激素及免疫抑制剂患者。首发症状均为发热、气促。血气分析5例为Ⅰ型呼吸衰竭。肺CT均表现为双侧弥漫性磨玻璃样渗出影。6例于支气管镜肺泡灌洗液中、2例于痰中找到肺孢子菌,1例痰肺孢子菌PCR阳性。7例均给予复方新诺明治疗,5例呼吸衰竭患者中,3例接受机械通气治疗,2例予鼻导管或面罩吸氧。5例治愈,2例死亡。结论非HIV感染者肺孢子菌肺炎起病急,容易并发呼吸衰竭,肺部影像学主要表现为双肺弥漫性渗出样改变。磺胺类药物治疗有一定疗效,合并呼吸衰竭的重症患者应及时给予呼吸支持。
Objective To study pneumocystis pneumonia （PCP） in the non-human immunodeficiency virus （HIV） infected patients. Methods The clinical data of 7 patients with PCP in non-HIV-infected immunocompromised from 2009 to 2011 in the hospital were reviewed. Results All of these patients had a long history of corticosteroid and immunosuppressive agents therapy. Fever was present in all patients combined with dyspnea. Five of them had type I respiratory failure. CT re- sults showed that bilateral diffuse ground-glass opacification in all patients. Pneumocystis was found in bronchoalveolar lavage fluid in 6 cases, sputum pneumocystis in 2 cases and positive pneumocystis PCR in 1 case. Three cases were conducted with mechanical ventilation and two cases had oxygen inhalation through a nasal tube or face mask in these five patients with respir- atory failure. Five patients were cured after treatment with SMZco, two patients were died due to respiratory failure. Conclu- sion Patients who have pneumocystis pneumonia without AIDS typically present with an abrupt onset of respiratory insuffi- ciency and complicated with respiratory failure frequently. Chest radiogram mainly shows bilateral diffuse ground-glass opacifi- cation. Sulfonamides are effective for the treatment and respiratory support should be conducted in critically ill patients with respiratory failure.
出处
《疑难病杂志》
CAS
2012年第8期600-602,共3页
Chinese Journal of Difficult and Complicated Cases
关键词
肺孢子菌肺炎
非HIV感染
免疫抑制
Pneumocystis pneumonia
Non-HIV infections
Immune suppression
