CAJ | 학술논문

目的：探讨2型糖尿病合并侵袭性肺曲霉病的临床特点及预后，加强临床医师对该病的警惕及认识，提高早期诊疗水平。方法回顾性分析2008年1月—2013年12月在青岛市市立医院呼吸科收治的9例单纯2型糖尿病合并侵袭性肺曲霉病患者的临床资料。结果9例2型糖尿病合并侵袭性肺曲霉病患者中确诊5例，临床诊断4例；临床表现以发热、咳嗽、咯痰为主；肺CT表现以沿支气管血管束分布的结节影，空洞征为主，支气管镜检查镜下可见气管或支气管黏膜充血水肿，局部黄白色或褐色脓苔覆盖，部分或完全阻塞管腔；经抗真菌治疗后4例好转，5例死亡。结论2型糖尿病是发生侵袭性肺曲霉病的高危因素，早期诊断与及时治疗是改善2型糖尿病合并侵袭性肺曲霉病预后的关键。
목적：탐토2형당뇨병합병침습성폐곡매병적림상특점급예후，가강림상의사대해병적경척급인식，제고조기진료수평。방법회고성분석2008년1월—2013년12월재청도시시립의원호흡과수치적9례단순2형당뇨병합병침습성폐곡매병환자적림상자료。결과9례2형당뇨병합병침습성폐곡매병환자중학진5례，림상진단4례；림상표현이발열、해수、각담위주；폐CT표현이연지기관혈관속분포적결절영，공동정위주，지기관경검사경하가견기관혹지기관점막충혈수종，국부황백색혹갈색농태복개，부분혹완전조새관강；경항진균치료후4례호전，5례사망。결론2형당뇨병시발생침습성폐곡매병적고위인소，조기진단여급시치료시개선2형당뇨병합병침습성폐곡매병예후적관건。
Objective To investigate the clinical characteristics and prognosis in the patients with type 2 diabetes mellitus and invasive pulmonary aspergillosis(IPA) for better management of the disease .Methods Clinical data of 9 cases of type 2 diabetes associated with IPA treated in Qingdao Municipal Hospital from January 2008 to December 2013 were analyzed retrospectively . Results The diagnosis of IPA was proven in 5 and probable in 4 of the 9 patients .The main clinical manifestations were fever , cough and expectoration .The findings of CT scan mainly showed pulmonary nodules along the bronchovascular bundle and cavity signs .Bronchoscopy showed congestion ,edema ,and erosion of bronchial mucosa covered with yellow‐white or brown pus ,partially or completely blocking the lumen .Antifungal treatment was effective for 4 patients .The other five patients died . Conclusions Type 2 diabetes mellitus is a risk factor for developing invasive pulmonary aspergillosis .Early diagnosis and proper treatment are critical for improved prognosis .