CAJ | 학술논문

目的：探讨研究肺孢子菌肺炎患者的临床特点、影像学表现及治疗方法。方法分析在我院诊断的肺孢子菌肺炎的31例患者的临床资料。结果31例患者中HIV/AIDS患者28例,非AIDS患者3例,其中男性22例,女9例,年龄23~75岁。主要临床表现为咳嗽,气促者28例(90．3%),发热25例(80．6%),咳痰17例(54．8%),乏力,纳差15例(48．3%),胸痛8例(25．8%),腹泻4例(12．9%),反复皮疹3例(9．6%)。3例患者行无创通气,1例因严重肺部感染,低氧血症,行有创机械通气。31例患者胸部CT均表现为典型的双肺弥漫性磨玻璃影,所有患者均选用复方磺胺甲基异噁唑治疗,对吸空气时血氧分压PaO2低于70 mmHg患者给予激素治疗。结论当AIDS患者或免疫抑制患者出现发热,咳嗽,呼吸困难,低氧血症,其胸部CT提示典型的双肺弥漫性磨玻璃影,需考虑PCP的可能,但其病原学检查困难,治疗以复方磺胺甲基异噁唑及激素治疗为主。
목적：탐토연구폐포자균폐염환자적림상특점、영상학표현급치료방법。방법분석재아원진단적폐포자균폐염적31례환자적림상자료。결과31례환자중HIV/AIDS환자28례,비AIDS환자3례,기중남성22례,녀9례,년령23~75세。주요림상표현위해수,기촉자28례(90．3%),발열25례(80．6%),해담17례(54．8%),핍력,납차15례(48．3%),흉통8례(25．8%),복사4례(12．9%),반복피진3례(9．6%)。3례환자행무창통기,1례인엄중폐부감염,저양혈증,행유창궤계통기。31례환자흉부CT균표현위전형적쌍폐미만성마파리영,소유환자균선용복방광알갑기이오서치료,대흡공기시혈양분압PaO2저우70 mmHg환자급여격소치료。결론당AIDS환자혹면역억제환자출현발열,해수,호흡곤난,저양혈증,기흉부CT제시전형적쌍폐미만성마파리영,수고필PCP적가능,단기병원학검사곤난,치료이복방광알갑기이오서급격소치료위주。
Objective To study the clinical characteristics, CT imaging feature and treatment of pneu-mocystis pneumonia ( PCP) . Methods The clinical data of 31 inpatients, who were diagnosed with PCP in the Cen-tral Hospital of Dazhou, were retrospectively analyzed. Results There were 28 cases co-infected with HIV and 3 ca-ses without HIV infection. The main clinical manifestations included cough and shortness of breath (90. 3%), fever (80. 6%), expectoration ( 54. 8%), fatigue and poor appetite ( 48. 3%), chest pain ( 25. 8%), diarrhea (12. 9%), and recurrent skin rash (9. 6%). Besides, 3 patients suffered from NPPV, and 1 patient suffered from IPPV because of serious lung infection and hypoxaemia. The chest CT scans of 31 patients were characterized with typical bilateral lung diffuse ground-glass opacity. Conclusion When patients with AIDS or immunosuppression have fever, cough, dyspnea and hypoxemia, and their chest CT scans show the typical bilateral lung diffuse ground-glass opacity, the possibility of PCP needs to be considered, but its etiological examination is difficult, so the treat-ment is given priority to SMZ and hormone therapy.