无基础疾病的肺隐球菌性病临床分析

Clinic analysis of pulmonary cryptococcosis without fundamental disease

目的探讨无基础疾病的原发性肺隐球菌病(PC)临床特点。影像学表现及临床常用的确诊方法。方法回顾2006年至今我科确诊的无基础疾病的肺隐球菌性病10例对其临床资料及?影像学特点及确诊方法进行分析及研究。结果10例病人均青壮年,无基础疾病,男性7例,女性3例,其中1例为体检发现,其余9例仅有轻微的咳嗽?咳痰症状,体格检查均无异常发现,影像学表现为:肺结节肿、块型、肺炎型其中1例有空洞形成,2例可见"晕轮征"。8例通过经皮肺穿刺活检确诊的,2例行隐球菌乳胶凝集试验阳性诊断。8例病人给以氟康唑治疗,2例给以伊曲康唑治疗病灶均明显吸收。结论原发性肺隐球菌病临床表现缺乏特异性,随着近年来发病率的增高,特别是无基础疾病的人群中应提高诊断意识,避免误诊,并应积极开展经皮肺穿刺活检及TBLB检查,避免开胸活检。

Objective To discuss clinic point of pulmonary eryptococcosis without fundamental disease, shadow exhibition and method of diagnose, and to improve the level of diagnosis. Methods 10 cases of pulmonary cryptococcosis without fundamental disease were studied, and their clinic data, shadow exhibition, diagnose method from 2006 until now in our hospital were examined. Results 10 cases were all juvenscence, without fundamental disease. There were 7 male, 3 female. Shadow exhibition showed lung tuber type, lumo type, and pneumoina type. 8 cases were diagnosed as perctanes lung puncture, and 2 cases as TBLB. Conclusion Clinic exhibition of pulmonary cryptococcosis is lacking characteristics, as the rate of incidence increasing in recent year, we should enhance our diagnose level, avoid mistake. The perctanes of lung puncture and TBLB should be given consideration, while opening the chest and avoiding biopsy.