摘要
目的探讨侵袭性肺曲霉病发病的高危因素、临床特点、影像学特征、治疗及预后因素。方法回顾分析2008年1月至2012年6月在本院确诊肺曲霉病感染的20例临床资料。结果20例侵袭性肺曲霉病患者中15例患者有免疫缺陷，5例既往体健。临床特点：发热14例（70％）、咳嗽12例（60％）、咳痰10例（50％）、气促8例（40％）、胸腔积液4例（20％）、胸痛4例（20％）、咯血12例（60％）等。影像学特征：结节影5例，团块影3例，磨玻璃浸润影2例，空洞4例及新月征3例，大片实变3例。治疗予抗真菌药物伏立康唑序贯疗法。预后为痊愈10例、显效5例、放弃2例、死亡3例。结论侵袭性肺曲霉病临床特点、影像学特征不特异，诊断依赖病原学及病理检查。对有免疫缺陷的患者早诊断、采用伏立康唑治疗，可提高治愈率，无高危因素的患者预后良好。
Objective To investigate high-risk factors, clinical features, imaging features, treatment and prognosis factors in the incidence of invasive pulmonary aspergillosis. Methods A retrospective analysis was carried out to 20 cases of clinical data in our hospital diagnosed as pulmonary aspergillosis infection from January 2008 to June 2012.Resuhs In the 20 cases of invasive pulmonary aspergillosis, there were 15 patients found with immunodeficiency, 5 cases of previously healthy. Clinical features： fever 14 cases （70%）, cough in 12 patients （60%）, sputum in 10 patients （50%）, shortness of breath, 8 cases （40%）, pleural effusion in 4 cases （20%）, 4 cases of chest pain （20%）, hemoptysis in 12 cases （60%）. Imaging features： 5 cases of nodules, lumps shadow 3 cases, 2 cases of ground-glass infiltrates, 4 cases of empty and crescent sign 3 cases, large tracts of real change 3 cases. 18 patients with the antifungal drug voriconazole, 2 cases of surgical treatment. Prognosis： cured 10 cases, 5 cases effective, 2 cases giving up, and 3 patients died. Conclusion The clinical features and imaging features of invasive pulmonary aspergillosis are not specific, the diagnosis relies on etiology and pathological examination. Early diagnosis to patients with immunodeficiency by using voriconazole therapy can improve the cure rate, and provide a good prognosis for patients without high risk factors.
出处
《国际医药卫生导报》
2012年第24期3594-3596,共3页
International Medicine and Health Guidance News
关键词
肺曲霉病
伏立康唑
Pulmonary aspergillosis
Voriconazole
