中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
21期
2577-2580,2583
,共5页
侵袭性肺曲霉菌病%糖尿病%诊断%治疗
侵襲性肺麯黴菌病%糖尿病%診斷%治療
침습성폐곡매균병%당뇨병%진단%치료
Invasive pulmonary aspergillosis%Diabetes mellitus%Diagnosis%Therapy
目的：分析糖尿病合并侵袭性肺曲霉菌感染临床诊治过程，提高对糖尿病合并侵袭性肺曲霉菌感染的诊治水平。方法复习南昌大学第二附属医院2013年11月确诊1例糖尿病合并侵袭性肺曲霉感染患者的临床资料及国内外相关文献，对侵袭性肺曲霉菌感染危险因素、早期诊断时间、血清学、胸部影像学以及药物治疗等方面进行分析。结果患者有2型糖尿病病史，胸部CT提示两肺多发结节影，晕轮征及多发空洞，肺组织化学染色阳性，肺组织发现曲霉菌丝，明确诊断为侵袭性肺曲霉菌感染，卡铂芬净联合伏立康唑补救治疗，患者临床治愈。结论糖尿病合并侵袭性肺曲霉菌感染早期诊断非常困难，病死率高，临床医师需提高认识，充分结合患者危险因素、血清学及早期胸部影像学检查诊断侵袭性肺真菌感染，抗真菌药物的联合运用可作为真菌感染的补救治疗方法，降低患者死亡风险。
目的：分析糖尿病閤併侵襲性肺麯黴菌感染臨床診治過程，提高對糖尿病閤併侵襲性肺麯黴菌感染的診治水平。方法複習南昌大學第二附屬醫院2013年11月確診1例糖尿病閤併侵襲性肺麯黴感染患者的臨床資料及國內外相關文獻，對侵襲性肺麯黴菌感染危險因素、早期診斷時間、血清學、胸部影像學以及藥物治療等方麵進行分析。結果患者有2型糖尿病病史，胸部CT提示兩肺多髮結節影，暈輪徵及多髮空洞，肺組織化學染色暘性，肺組織髮現麯黴菌絲，明確診斷為侵襲性肺麯黴菌感染，卡鉑芬淨聯閤伏立康唑補救治療，患者臨床治愈。結論糖尿病閤併侵襲性肺麯黴菌感染早期診斷非常睏難，病死率高，臨床醫師需提高認識，充分結閤患者危險因素、血清學及早期胸部影像學檢查診斷侵襲性肺真菌感染，抗真菌藥物的聯閤運用可作為真菌感染的補救治療方法，降低患者死亡風險。
목적：분석당뇨병합병침습성폐곡매균감염림상진치과정，제고대당뇨병합병침습성폐곡매균감염적진치수평。방법복습남창대학제이부속의원2013년11월학진1례당뇨병합병침습성폐곡매감염환자적림상자료급국내외상관문헌，대침습성폐곡매균감염위험인소、조기진단시간、혈청학、흉부영상학이급약물치료등방면진행분석。결과환자유2형당뇨병병사，흉부CT제시량폐다발결절영，훈륜정급다발공동，폐조직화학염색양성，폐조직발현곡매균사，명학진단위침습성폐곡매균감염，잡박분정연합복립강서보구치료，환자림상치유。결론당뇨병합병침습성폐곡매균감염조기진단비상곤난，병사솔고，림상의사수제고인식，충분결합환자위험인소、혈청학급조기흉부영상학검사진단침습성폐진균감염，항진균약물적연합운용가작위진균감염적보구치료방법，강저환자사망풍험。
Objective To review the clinical diagnosis and treatment of invasive pulmonary aspergillus infection complicated with diabetes, and to improve the diagnosis and treatment level of invasive pulmonary aspergillus infection complicated with diabetes.Methods The clinical data of a case of invasive pulmonary aspergillosis complicated with diabetes in the Second Affliated Hospital of Nanchang University and related domestic and foreign literatures were reviewed, and the risk factors, early diagnosis time, serology, chest imaging and drug treatment of invasive pulmonary aspergillosis were analyzed.Results The patients had a history of type 2 diabetes.The chest CT showed nodular shadows, halo sign and multiple cavitates in both lungs, chemical staining of lung tissue was positive, aspergillus silk was found in lung tissue, so the case was clearly diagnosed as invasive pulmonary aspergillosis, after treatment with voriconazole and voriconazole, the case was clinically cured.Conclusion The early diagnosis of invasive pulmonary aspergillus infection complicated with diabetes is very difficult, the disease has high mortality.To raise diagnosis rate, clinicians should raise awareness of risk factors, serology and early chest imaging examination of invasive pulmonary fungal disease.The joint use of antifungal drugs can be used as the remedial treatment of fungal infections, thus the risk of death can be decreased.
