原发性肺隐球酵母菌病临床分析

Primary Pulmonary Cryptococcosis:A Retrospective Analysis of Sixteen Cases

目的了解肺隐球酵母菌病的临床特点及治疗方法。方法回顾1982—2007年1月经病理确诊肺隐球酵母菌病16例临床资料，对肺隐球菌酵母病的临床症状、影像学资料、确诊方法及治疗进行分析。结果16例原发性肺隐球酵母菌病多为中青年，多数患者发病前健康良好。经手术治疗、抗真菌治疗，随访6个月～5年，无肺隐球酵母菌病复发、全身播散及死亡。结论原发性肺隐球菌酵母病多无基础疾病，影像学表现单发或多发结节、肿块影、肺实质浸润影；病变局限者可采取手术切除，术后抗真菌治疗，多发病变应抗真菌治疗为主，氟康唑为治疗肺隐球酵母菌病的首选药物。

OBJECTIVE To investigate the clinical pathologic features and therapeutic tools of pulmonary cryptococcosis. METHODS The clinical data about 16 cases of pulmonary cryptococcosis which were diagnosed by histopathologic examinations were reviewed. The survey data recorded over a 15-year period, from 1982 to 2007, were summarized. We analyzed their clinical situations, radiographic manifestations, final diagnosis and therapeutic tools. RESULTS The majority of the patients were middle-aged males. The health condition of the most of the patients was good before infection, six months to five years after surgery and antifungal theragy, no relapse, dissemination and death were observed. CONCLUSIONS The majority of primary pulmonary cryptococcosis patients have not underlying diseases,and their radiography manifestations show single or multiple nodular shadows, tumor shadows and infiltrative shadows. The limited pathological change can be excised and applied with the antifungal drugs. Fluconazole is the first-choice drug for curing pulmonary cryptococcosis.