非艾滋病免疫功能抑制患者肺孢子菌肺炎的临床特点及诊治探讨

发布时间：2018-05-01 23:35

  本文选题：肺孢子菌肺炎 + 非获得性免疫缺陷综合征　； 参考：《中华医院感染学杂志》2014年06期

【摘要】：目的研究非艾滋病(AIDS)免疫功能抑制患者发生肺孢子菌肺炎(PCP)的临床特点并对β-D-葡聚糖的诊断价值和治疗药物进行探讨。方法回顾性分析呼吸科2010年7月-2011年6月收治的15例非AIDS免疫功能抑制患者发生PCP的临床表现、实验室检查、治疗及转归,采用STATA 8.0统计软件。结果所有患者发生PCP前均接受了激素或免疫抑制剂治疗,其中14例应用了泼尼松或甲泼尼龙,9例应用了吗替麦考酚酯,15例患者平均APACHEⅡ评分为(16±5)分,氧合指数均300mm Hg,66.7%的患者CD4淋巴细胞计数200/μl,93.3%的患者血清β-D-葡聚糖升高;所有患者的抗PCP治疗均联合应用了卡泊芬净和磺胺甲恶唑/甲氧苄啶,总体病死率26.7%,接受无创通气或有创机械通气患者病死率为50.0%,高于未接受无创通气或有创机械通气患者(P=0.077)。结论非AIDS免疫功能抑制患者中PCP的病死率较高,β-D-葡聚糖可以做为PCP感染的一个诊断参考指标,卡泊芬净联合磺胺甲恶唑/甲氧苄啶治疗PCP有效。
[Abstract]:Objective to study the clinical features of PCPP in patients with Pneumocystis pneumocystis pneumonia (PCPP) in patients with non-AIDS AIDS immunosuppression, and to explore the diagnostic value and therapeutic drugs of 尾 -Dglucan. Methods the clinical manifestation, laboratory examination, treatment and outcome of PCP in 15 patients with non AIDS immunosuppression admitted from July 2010 to June 2011 were analyzed retrospectively. STATA 8.0 software was used. Results all patients were treated with hormone or immunosuppressant before PCP, of which 14 received prednisone or methylprednisolone in 9 patients, and the average APACHE 鈪，

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