艾滋病合并卡氏肺孢子菌肺炎5例临床观察

发布时间：2018-06-20 11:50

本文选题：艾滋病 + 卡氏肺孢子虫肺炎　；参考：《中国现代医生》2016年10期

【摘要】：目的探讨艾滋病(AIDS)合并卡氏肺孢子菌肺炎(PCP)的临床表现、诊断和治疗。方法采用回顾性分析的方法收集宁夏医科大学总医院感染疾病科自2014年10月~2015年1月间收治的艾滋病合并卡氏肺孢子菌肺炎患者的临床特点、实验室检查和64排螺旋CT表现。结果咳嗽、持续低热、进行性呼吸困难、紫绀是PCP最常见的临床症状,CD~(4+)T淋巴细胞数为(1~400)个/μL;典型影像学表现为双肺弥漫性磨玻璃样渗出影;PCP患者均采用复方磺胺甲基异恶唑(SMZco)治疗,如动脉血氧分压70 mmHg联合强的松治疗,如合并其他机会性感染予以相应的治疗;其中3例患者好转,1例患者死亡,1例患者放弃治疗自动出院。大多数患者因合并其他病原菌感染而死亡,且其CD~(4+)T淋巴细胞计数明显低于病情好转的患者。结论 PCP主要发生在AIDS晚期,如AIDS患者有低热、呼吸困难、低氧血症、体重下降等临床表现,且胸部CT表现为间质纹理增粗、模糊或呈磨玻璃状阴影,需留心AIDS合并PCP的可能,应早期给予SMZco治疗,严重患者可联合糖皮质激素冲击治疗。
[Abstract]:Objective to investigate the clinical manifestation, diagnosis and treatment of AIDS with Pneumocystis carinii pneumonia. Methods the clinical features, laboratory examination and 64-slice spiral CT findings of AIDS patients with pneumocystis carinii pneumonia admitted from October 2014 to January 2015 were collected by retrospective analysis. Results cough, persistent low fever, progressive dyspnea, Cyanosis is the most common clinical symptom of PCP. For example, the arterial partial pressure of oxygen 70 mmHg combined with prednisone, if combined with other opportunistic infections, should be treated accordingly, of which 3 patients had improved and 1 patient had died, and 1 patient had given up treatment and been discharged automatically. Most of the patients died from other pathogens, and the T lymphocyte count was significantly lower than that in the patients with improved condition. Conclusion PCP mainly occurs in the late stage of AIDS, such as low fever, dyspnea, hypoxemia, weight loss and so on. SMZco should be given early treatment, severe patients can be combined with glucocorticoid shock therapy.
【作者单位】：宁夏医科大学;宁夏医科大学总医院感染疾病科;
【分类号】：R512.91;R563.1

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