2型糖尿病合并侵袭性肺曲霉病9例临床分析

发布时间：2018-01-03 05:16

本文关键词：2型糖尿病合并侵袭性肺曲霉病9例临床分析　出处：《中国感染与化疗杂志》2015年05期 　论文类型：期刊论文

【摘要】：目的探讨2型糖尿病合并侵袭性肺曲霉病的临床特点及预后,加强临床医师对该病的警惕及认识,提高早期诊疗水平。方法回顾性分析2008年1月—2013年12月在青岛市市立医院呼吸科收治的9例单纯2型糖尿病合并侵袭性肺曲霉病患者的临床资料。结果 9例2型糖尿病合并侵袭性肺曲霉病患者中确诊5例,临床诊断4例;临床表现以发热、咳嗽、咯痰为主;肺CT表现以沿支气管血管束分布的结节影,空洞征为主,支气管镜检查镜下可见气管或支气管黏膜充血水肿,局部黄白色或褐色脓苔覆盖,部分或完全阻塞管腔;经抗真菌治疗后4例好转,5例死亡。结论 2型糖尿病是发生侵袭性肺曲霉病的高危因素,早期诊断与及时治疗是改善2型糖尿病合并侵袭性肺曲霉病预后的关键。
[Abstract]:Objective to investigate the clinical characteristics and prognosis of patients with invasive pulmonary aspergillosis in type 2 diabetes, strengthen the clinician vigilance and awareness of the disease, improve the early diagnosis and treatment level. Methods Retrospective analysis of clinical data of patients with invasive pulmonary aspergillosis in patients with type 2 diabetes mellitus in January 2008 December 2013 in Qingdao municipal Hospital Department of respiration treated 9 cases of simple results. 9 patients with type 2 diabetes mellitus patients with confirmed pulmonary aspergillosis invasion in 5 cases, 4 cases of clinical diagnosis; clinical manifestations were fever, cough, expectoration; pulmonary CT manifestations of nodules located along the bronchovascular bundle, empty sign, bronchoscopy microscopically tracheal or bronchial mucosal congestion and edema, covering local yellow white or brown pus, partial or complete occlusion of the lumen; after antifungal therapy, 4 cases improved, 5 cases died. Conclusion type 2 diabetes are risk factors of invasive pulmonary aspergillosis , early diagnosis and timely treatment is the key to improve type 2 diabetes mellitus complicated with invasive pulmonary aspergillosis prognosis.

【作者单位】：青岛市市立医院呼吸科;
【分类号】：R519;R587.1
【正文快照】： 随着广谱抗生素、糖皮质激素、细胞毒药物及免疫抑制剂应用的增多,侵袭性肺曲霉病(invasivepulmonary aspergillosis,IPA)作为一种临床少见病,其发病率也在逐年增多。2型糖尿病患者,尤其是血糖控制不佳的患者,由于长期血糖升高,导致机体细胞免疫功能下降,白细胞趋化活性、黏附

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