艾滋病合并肺孢子菌肺炎23例临床分析
作者:
作者单位:

作者简介:

王敏

通讯作者:

中图分类号:

R512.91

基金项目:


Clinical analysis of 23 cases of Pneumocystis pneumonia in patients with acquired immunodeficiency syndrome
Author:
Affiliation:

Fund Project:

  • 摘要
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 文章评论
    摘要:

    目的探讨艾滋病(AIDS)合并肺孢子菌肺炎(PCP)患者的临床特点、诊断及治疗转归。方法通过计算机病案信息系统搜索AIDS合并PCP患者,并对其临床资料进行回顾性分析,将患者分为呼吸衰竭组(11例)与无呼吸衰竭组(12例),比较两组患者动脉血氧分压(PaO2)值、血氧饱和度(SaO2)、CD4+T淋巴细胞及乳酸脱氢酶(LDH)。结果23例AIDS合并PCP患者常见的症状为体重减轻,口腔黏膜白斑,气促、呼吸困难,发热,咳嗽,咳痰。 23例患者PaO2 值为(78.65±30.85)mmHg,二氧化碳分压(PaCO2)为(24.42±5.60) mmHg,pH值为(7.43±0.79),SaO2为(91.16±9.55)%;呼吸衰竭组SaO2、PaO2值低于无呼吸衰竭组,差异有统计学意义(均P<0.05)。肺部CT主要表现为两肺不同程度磨玻璃样改变。21例患者使用复方磺胺甲口恶唑片抗PCP治疗,1例使用复方磺胺甲口恶唑片+克林霉素治疗,1例单用克林霉素治疗,17例患者加用肾上腺糖皮质激素治疗;治疗后20例患者好转,2例死亡,1例放弃治疗。结论AIDS合并PCP患者常见症状为亚急性进行性呼吸困难、发热、干咳,肺部CT常显示磨玻璃样改变,可予以复方磺胺甲口恶唑片或复方磺胺甲口恶唑片+克林霉素联合治疗,肾上腺糖皮质激素可明显缓解患者症状。

    Abstract:

    ObjectiveTo investigate the clinical characteristics,diagnosis and therapeutic prognosis of Pneumocystis pneumonia(PCP)in patients with acquired immunodeficiency syndrome (AIDS).MethodsAIDS  patients with PCP were searched through computer medical record information system, clinical data were analyzed retrospectively, patients were divided into respiratory failure group (n=11) and nonrespiratory failure group (n=12),partial pressure of oxygen in arterial blood(PaO2), degree of blood oxygen saturation(SaO2),CD4+T lymphocyte, and lactate dehydrogenase(LDH)between two groups were compared.Results23 patients generally had the symptoms of weight loss,oral leukoplakia,shortness of breath, dyspnea, fever, cough,and expectoration. PaO2 value in 23 patients was (78.65±30.85)mmHg, partial pressure of carbon dioxide(PaCO2)was (24.42±5.60) mmHg,pH value was(7.43±0.79),SaO2 was (91.16±9.55)%;SaO2 and PaO2 in  respiratory failure group was lower than  nonrespiratory failure group, the difference was significant (both P<0.05).Lung computed tomography (CT) scans showed bilateral pulmonary groundglasslike change. 21 patients used compound sulfamethoxazole tablets, 1 patient used compound sulfamethoxazole tablets plus clindamycin,1 patient used only clindamycin,17 patients used glucocorticoid in addition to compound sulfamethoxazole;after treatment,20 patients improved,2 died,and 1 gave up treatment.ConclusionSubacute progressive dyspnea, fever, dry cough,and lung groundglasslike shadow are common symptoms of PCP in AIDS patients,  compound sulfamethoxazole or compound sulfamethoxazole with clindamycin can be used for treatment, glucocorticoid  can obviously alleviate the symptoms of patients.

    参考文献
    相似文献
引用本文

马孝煜,王敏 ,等.艾滋病合并肺孢子菌肺炎23例临床分析[J]. 中国感染控制杂志,2015,14(7):459-463. DOI:10.3969/j. issn.1671-9638.2015.07.007.
MA Xiaoyu, WANG Min, et al. Clinical analysis of 23 cases of Pneumocystis pneumonia in patients with acquired immunodeficiency syndrome[J]. Chin J Infect Control, 2015,14(7):459-463. DOI:10.3969/j. issn.1671-9638.2015.07.007.

复制
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2014-12-18
  • 最后修改日期:2015-02-23
  • 录用日期:
  • 在线发布日期: 2015-07-30
  • 出版日期: