艾滋病合并肺孢子菌肺炎23例临床分析

发布时间：2018-02-24 11:12

本文关键词： 人类免疫缺陷病毒艾滋病 HIV AIDS 肺孢子菌肺炎 PCP 复方磺胺甲口恶唑　出处：《中国感染控制杂志》2015年07期 　论文类型：期刊论文

【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P0.05)。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]:Objective to investigate the clinical features, diagnosis and treatment of patients with AIDS complicated with Pneumocystis pneumocystis pneumonia. Methods the patients with AIDS complicated with PCP were searched by computer medical record information system, and their clinical data were analyzed retrospectively. Patients were divided into respiratory failure group (n = 11) and non-respiratory failure group (n = 12). Results the common symptoms of AIDS combined with PCP were weight loss, oral leukoplakia, shortness of breath, dyspnea, fever, cough, etc. The PaO2 value of expectoration was 78.65 卤30.85mmHg, and Paco _ 2 was 24.42 卤5.60 mm 路h ~ (-1) (pH = 7.43 卤0.79 卤0.79 卤0.79), and the Pao _ 2 value of respiratory failure group was lower than that of non-respiratory failure group, and the Pao _ 2 value of respiratory failure group was lower than that of non-respiratory failure group. The difference was statistically significant (all P 0.05). Lung CT showed that 21 patients with different degree of glass-like change of both lungs were treated with compound sulfamethoxazole tablets against PCP and 1 case with clindamycin compound sulfamethoxazole tablets. One case was treated with clindamycin alone and 17 cases were treated with adrenal glucocorticoid. Conclusion the common symptoms of AIDS combined with PCP are subacute progressive dyspnea, fever, dry cough, and lung CT findings. Compound sulfamethoxazole tablets or compound sulfamethoxazole tablets clindamycin combined treatment, adrenal glucocorticoid can significantly alleviate the symptoms of patients.
【作者单位】：中南大学湘雅医院;长沙市第一医院艾滋病研究所;
【分类号】：R512.91;R563.1

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