隐球菌病69例临床分析

发布时间：2018-02-28 10:49

本文关键词： 隐球菌病病理诊断影像学特征治疗　出处：《南京医科大学学报(自然科学版)》2017年09期 　论文类型：期刊论文

【摘要】：目的 :了解隐球菌病的临床特征,提高临床医生对隐球菌病的认识。方法 :回顾性分析南京医科大学第一附属医院2007—2015年收治的69例确诊的隐球菌病患者。免疫功能正常和免疫功能受损的患者分别是43例和26例。结果 :最常见的感染部位是呼吸系统,其次是中枢神经系统。肺隐球菌病患者中,病变主要位于周围肺野和下肺;21例肺隐球菌病曾被误诊;PET/CT检查单发结节易误诊为肿瘤;41例肺隐球菌患者接受药物、手术或联合治疗,34例痊愈无复发,1例改善,1例死亡,5例失访。28例其他部位(隐球菌脑膜炎、隐球菌血症等)隐球菌病患者治愈15例,死亡10例,失访3例。结论:研究发现,隐球菌病患者中免疫功能正常患者的比例较高。呼吸系统最易感染,病变通常位于外周肺野和下肺,PET/CT仍可导致误诊。抗真菌治疗对肺隐球菌病治疗效果较好。隐球菌脑膜炎、隐球菌血症病死率高。
[Abstract]:Objective: to investigate the clinical features of Cryptococcosis. Methods: 69 patients with cryptococcosis admitted from 2007 to 2015 in the first affiliated Hospital of Nanjing Medical University were analyzed retrospectively. The patients with normal immune function and impaired immune function were analyzed retrospectively. There were 43 cases and 26 cases. Results: the most common site of infection was the respiratory system. In the patients with pulmonary cryptococcosis, 21 patients with pulmonary cryptococcosis were misdiagnosed by PET / CT, and 41 patients with pulmonary Cryptococcus pneumoniae were misdiagnosed by PET / CT. Surgical or combined treatment of 34 cases with complete recovery, 1 case with no recurrence, 1 case with improvement, 1 case of death, 5 cases of missing visit. 28 cases of other sites (Cryptococcus meningitis, Cryptococcosis, etc.) were cured in 15 cases, dead in 10 cases, lost in 3 cases. The proportion of patients with normal immune function is higher in patients with cryptococcosis. The respiratory system is the most susceptible to infection. The lesions usually located in the peripheral lung field and the lower lung can still lead to misdiagnosis. Antifungal therapy is effective in the treatment of pulmonary cryptococcosis. The mortality rate of Cryptococcinemia is high.
【作者单位】：南京医科大学第一附属医院呼吸与危重症医学科;南京医科大学第一附属医院核医学科;
【基金】：基金项目江苏省呼吸病临床医学研究中心 (BL2012012)
【分类号】：R519.4

【相似文献】