摘要
目的探讨艾滋病患者中卡氏肺孢菌性肺炎的临床特征、诊断方法及治疗预防措施。方法对36例艾滋病患者合并卡氏肺孢菌性肺炎病例资料进行回顾性描述和分析。结果艾滋病患者CD4+T淋巴细胞低于200/μL时,易发生卡氏肺孢菌性肺炎机会感染。36例患者临床表现为发热、咳嗽、气促、低氧血症、呼吸衰竭,7例找到肺孢子菌包囊,确诊PCP,其余29例为临床诊断。通过复方磺胺甲恶唑联合卡泊芬净并辅以糖皮质激素治疗,取得较好疗效,9例痊愈,27例症状明显好转,无死亡病例。结论艾滋病患者若出现快速进展的低氧血症伴CD4+T淋巴细胞低于200/μL及乳酸脱氢酶升高者应警惕卡氏肺孢菌性肺炎,早期诊断、早期应用以复方磺胺甲恶唑联合卡泊芬净为基础的综合治疗是提高生存率的关键。
Objective To investigate clinical characteristics,diagnostic methods,treatment and prevention measures of Pneumocystis cafinii pneumonia(PCP) in patients with Acquired Immunodeficiency Syndrome(AIDS).Methods The clinical data of 36 AIDS patients with PCP were retrospectively described and analyzed.Results AIDS patients were prone to develop PCP when their count of CD4+ T lymphocytes was less than 200/μL.The clinical manifestations of the 36 patients included fever,cough,short breath,hypoxemia and respiratory failure.7 cases were diagnosed as PCP because of Pneumocystis cysts,and the remaining 29 cases were clinical diagnosis.9 cases were cured and 27 cases improved significantly in symptoms by treating with sulfamethoxazole combined with caspofungin and supplemented by glucocorticoid,while no deaths were found.Conclusion PCP could develop when AIDS patients suffer rapidly progressive hypoxemia with CD4+ T lymphocytes less than 200/μL and elevated lactate dehydrogenase.It is essential to early diagnose and use sulfamethoxazole combined with caspofungin in AIDS patients with PCP in order to increase the survival rate of these patients.
出处
《中国微生态学杂志》
CAS
CSCD
2013年第4期412-415,共4页
Chinese Journal of Microecology
基金
湖州市科技局资助项目(2011YS35)
