艾滋病合并肺孢子菌肺炎的MSCT表现与G试验的关系

发布时间：2018-04-30 09:29

本文选题：获得性免疫缺陷综合征 + 卡氏肺孢子菌肺炎　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:探讨艾滋病(Acquired Immune Deficiency Syndrome,AIDS,获得性免疫缺陷综合征)合并肺孢子菌肺炎(Pneumocystis Pneumonia,Pneumocystis jurovecii Pneumonia,PCP/PJP)的MSCT多样性表现与(1→3)-β-D-葡聚糖((1→3)-β-D-Glucan,G test,G试验,BDG)之间的关系。方法:收集吉林大学白求恩第一医院呼吸内科病房2013年1月~2016年1月收治的35例艾滋病合并肺孢子菌肺炎患者的临床资料,患者均是通过临床确诊的肺孢子菌肺炎,为排除抗结核药物与抗逆转录病毒药物之间的相互作用,故剔除5例已经行抗结核治疗及抗逆转录病毒治疗的患者。故本研究共入组30例患者,其中男性29例,女性1例,患者平均年龄(44.5±13.6岁)。回顾性分析入组的30例艾滋病合并肺孢子菌肺炎患者MSCT表现与(1→3)-β-D-葡聚糖检测结果,将二者进行对照研究,并进行统计学分析。结果:26例(86.7%)艾滋病合并肺孢子菌肺炎患者(1→3)-β-D-葡聚糖95 pg/m L,1例(3.3%)艾滋病合并肺孢子菌肺炎患者(1→3)-β-D-葡聚糖70~95 pg/m L,3例(10.0%)艾滋病合并肺孢子菌肺炎患者(1→3)-β-D-葡聚糖70 pg/m L;肺孢子菌肺炎影像学分型中各型之间(1→3)-β-D-葡聚糖差异无统计学意义(P0.05);影像学分期中各期之间(1→3)-β-D-葡聚糖差异无统计学意义(P0.05);肺孢子菌肺炎影像学分型与(1→3)-β-D-葡聚糖之间相关系数r=-0.056,P=0.770;肺孢子菌肺炎影像学分期与(1→3)-β-D-葡聚糖之间相关系数r=-0.088,P=0.644;肺孢子菌肺炎影像学分型与分期之间相关系数r=0.969,P=0.000。结论:当患者确诊为艾滋病,尚不宜行支气管镜等有创检查取病PCP病原学诊断者,MSCT表现为间质性肺炎,G试验计数升高则提示合并PCP可能性大;艾滋病合并PCP患者G试验计数显著升高,虽然可以为临床诊断PCP提供血清学参考价值,但其数值高低与患者MSCT严重程度分型及分期无相关性,不能作为评估病情严重程度及治疗效果的指标。
[Abstract]:Objective: to investigate the relationship between the MSCT diversity of Pneumocystis jurovecii Pneumocystis Pneumocystis Pneumocystis Pneumoniae Pneumoniae PCPP / PJPP and the relationship between MSCT diversity and 尾 -Dglucan 133- 尾 -D-Glucananum G test G test in Pneumocystis jurovecii Pneumoniae Pneumocystis Pneumocystis jurovecii. Methods: the clinical data of 35 patients with Pneumocystis pneumonia from January 2013 to January 2016 in the Department of Respiratory Medicine of Bai Qiuen first Hospital of Jilin University were collected. All the patients were diagnosed as pneumocystis pneumonia. In order to eliminate the interaction between antituberculous and antiretrovirals, five patients who had been treated with antituberculous and antiretrovirals were excluded. Therefore, there were 30 patients in this study, including 29 males and 1 female. The average age of the patients was 44.5 卤13.6 years old. The MSCT findings of 30 patients with Pneumocystis pneumonia and the results of 尾 -Dglucan were analyzed retrospectively. The results were compared and statistically analyzed. Results among 26 patients with Pneumocystis pneumocystis pneumonia, 1 case was infected with Pneumocystis pneumocystis pneumonia, 1 case was treated with Pneumocystis pneumonia, 3 cases were treated with Pneumocystis pneumonia, 3 cases with Pneumocystis pneumocystis pneumonia, 3 cases with AIDS complicated with Pneumocystis pneumonia, 1 case with Pneumosporidium pneumonia, 1 case with Pneumocystis pneumocystis pneumonia. Glycomannan 70 pg/m L; Pneumocystis pneumoniae in imaging classification; P0.05; P0.05 in imaging stages; P0.05 in pneumocystis pneumonia; P0.05in Pneumocystis pneumocystis pneumonia. The correlation coefficient between the classification of Pneumocystis pneumoniae and the imaging stage of Pneumocystis pneumoniae and the correlation coefficient between the imaging stage of Pneumocystis pneumoniae and the stage of P0. 644 was 0. 088% P0. 644. The correlation coefficient between the imaging classification and the stage of Pneumocystis pneumonia was 0. 969P0. 000. Conclusion: if the patient is diagnosed with AIDS, it is not advisable to take out the PCP etiology diagnosis by bronchoscopy and other invasive examinations. If the count of G test of interstitial pneumonia is increased, it is suggested that there is a great possibility of complicated with PCP. G test count was significantly increased in patients with PCP, although it could provide serological reference value for clinical diagnosis of PCP, but its value had no correlation with severity classification and stage of MSCT. It can not be used as an index to evaluate the severity of the disease and the effect of treatment.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.91;R519

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