非免疫缺陷肺隐球酵母菌病患者的临床分析

发布时间：2018-04-06 07:39

本文选题：非免疫缺陷　切入点：肺隐球酵母菌　出处：《中华医院感染学杂志》2015年12期

【摘要】：目的研究非免疫缺陷肺隐球酵母菌病好转的临床特点,分析其临床特征和诊断方法,提高对肺隐球酵母菌病的认识和诊治水平。方法回顾性分析2009-2014年20例非免疫缺陷肺隐球酵母菌病患者的临床表现、影像学改变、实验室检查、病理表现、治疗与转归,研究数据采用SPSS13.0统计软件进行分析。结果 20例非免疫缺陷肺隐球酵母菌病患者中4例临床表现不明显,其主要临床表现以咳嗽及乏力为主,肺部CT表现为近胸膜团块实变影9例、病灶周围伴有晕征6例、空洞及纵隔淋巴结肿大各2例,分别占45.0%、30.0%、10.0%、10.0%,初诊时误诊12例,误诊率高达60.0%;经氟康唑或伏立康唑等抗真菌治疗后,患者肺部病灶明显吸收,随访未见其他脏器播散。结论非免疫缺陷肺隐球酵母菌病临床症状较轻,近胸膜团块实变影及病灶周围伴有晕征是其较常见的影像学表现,氟康唑是治疗的首选药物,治疗效果良好,愈后未见复发。
[Abstract]:Objective to study the clinical features of the improvement of nonimmune deficiency pulmonary cryptoglobulomycosis, analyze its clinical characteristics and diagnostic methods, and improve the understanding, diagnosis and treatment of pulmonary cryptoglobulomycosis.Methods the clinical manifestations, imaging changes, laboratory examination, pathological findings, treatment and outcome of 20 patients with non-immunodeficient pulmonary cryptoglobulomycosis from 2009 to 2014 were analyzed retrospectively. The data were analyzed by SPSS13.0 software.Results the clinical manifestations of 4 cases of nonimmunodeficient pulmonary cryptoglobulomycosis were not obvious. The main clinical manifestations were cough and fatigue. The CT findings of lung showed solid changes of proximal pleural mass in 9 cases and halo sign around the lesion in 6 cases.The cavity and mediastinal lymph nodes were enlarged in 2 cases, accounting for 45.0% and 10.0%, 12 cases were misdiagnosed at first visit, the misdiagnosis rate was as high as 60.0.After antifungal therapy such as fluconazole or voriconazole, the pulmonary lesions were absorbed obviously, but no other organs were spread during follow-up.Conclusion the clinical symptoms of nonimmunodeficient pulmonary cryptoglobulomycosis are mild, the near pleural mass consolidation and the surrounding halo sign are the most common imaging manifestations of the disease. Fluconazole is the first choice in the treatment of the disease. Fluconazole is the first drug in the treatment, and it has no recurrence after recovery.
【作者单位】：金华市人民医院呼吸内科;
【基金】：浙江省科技厅研究基金资助项目(201301259)
【分类号】：R519

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