CAJ | 학술논문

目的探讨非人类获得性免疫缺陷病毒感染的免疫低下宿主肺炎的临床特征.方法回顾性分析550例免疫低下宿主肺炎的胸部影像学改变、肺功能检测结果、肺炎发生时的体温、外周血白细胞及中性粒细胞绝对值计数、病原学检查结果、血清免疫功能指标、治疗及转归.结果所有患者均具有影像学可识别的肺炎表现;部分患者出现了肺功能异常、且以弥散功能障碍为主;96.4%的患者在肺炎发生时有发热、且以高热为主;白细胞减少者478例(86.9%)、其中粒缺者338例;315例(57.3%)患者无病原学依据;235例有病原学资料的患者中细菌感染占首位,混合感染87例、占所有病例的15.8%,其中细菌与真菌、细菌与细菌、细菌与病毒的混合感染居多,分别有40、27和9例;细菌和真菌败血症共64例(11.6%)、人巨细胞病毒抗原血症12例(2.2%);死亡22例、自动出院40例、治疗成功率88.7%.结论免疫低下宿主肺炎中,发热、尤其是高热是其重要体征;细菌感染是首要病因、混合感染常见;败血症的发生率高;经验性抗感染治疗占据主导地位.
목적 탐토비인류획득성면역결함병독감염적면역저하숙주폐염적림상특정.방법 회고성분석550례면역저하숙주폐염적흉부영상학개변、폐공능검측결과、폐염발생시적체온、외주혈백세포급중성립세포절대치계수、병원학검사결과、혈청면역공능지표、치료급전귀.결과 소유환자균구유영상학가식별적폐염표현;부분환자출현료폐공능이상、차이미산공능장애위주;96.4%적환자재폐염발생시유발열、차이고열위주;백세포감소자478례(86.9%)、기중립결자338례;315례(57.3%)환자무병원학의거;235례유병원학자료적환자중세균감염점수위,혼합감염87례、점소유병례적15.8%,기중세균여진균、세균여세균、세균여병독적혼합감염거다,분별유40、27화9례;세균화진균패혈증공64례(11.6%)、인거세포병독항원혈증12례(2.2%);사망22례、자동출원40례、치료성공솔88.7%.결론 면역저하숙주폐염중,발열、우기시고열시기중요체정;세균감염시수요병인、혼합감염상견;패혈증적발생솔고;경험성항감염치료점거주도지위.
Objective To explore the clinical features of immunocompromised hosts pneumonia without HIV infection.Methods The data(such as chest X-ray,pulmonary function,temperature,peripheral blood granulocyte count,pathogens,sero-immunity index,management and prognosis)of 550 immunocompromised hosts pneumonia were analyzed retrospectively.Results All patients had pneumonic changes in chest X-ray,some of them had abnormal diffusion function,96.4%of 550 paitents had fever when pneumonia occurred,most of them were hyperpyrexia.There were 478(86.9%)patients with granulocytopenia and 338 patients among them were agranulocytosis.315(57.3%)patients had no pathogens detected.Among the rest 235 patients with pathogens detected,bacterial infection were the first reason,87 (15.8%)patients were of mixed infection.There were 64 cases of septicemia with bacteria or fungi,and 12 antigenaemia of CMV.22 patients died of pneumonia and 40 patients gave up therapy because of their deteriorated conditions,the improvement rate was 88.7%overall.Conclusions Hyperpyrexia is one of the most important signs of immunocompromised hosts pneumonia without HIV infection.Bacteria are the main pathogens.Mixed infection or polymicrobial infection occur more often.Septicemia are very common.Empirical antimicrobial treatment iS the leading measure.