肺曲霉菌感染的临床分析

Clinical analysis on pulmonary aspergillosis infection

目的总结肺曲霉菌感染的临床特点和诊治的经验,从而提高人们对肺曲霉菌病的认识。方法对2008年6月至2010年12月收治的17例确诊为肺曲霉菌病的患者的临床特点进行回顾性分析。结果肺曲霉菌病的患病率有所增高,多发生在免疫功能低下,高龄老年及长期应用多种抗生素、糖皮质激素、免疫抑制剂、多种基础病史的患者,病死率较高。临床表现主要有:长期高热、气短、咳嗽、咳黏液痰、痰中带血或咯血等。其中以发热、咯血多见。CT可表现为"晕轮征"。结论肺曲霉菌感染临床表现缺乏特异性、预后不佳。应早期诊断,并早期给予足量、足疗程的抗真菌治疗,一般可选用伏立康唑、伊曲康唑、卡泊芬净或两性霉素B脂质体等抗真菌药物。

Objective To summarize the clinical characteristics and experience in treatment of pulmonary aspergillosis.Methods Retrospective study on clinical characterisics and nosogenesis in 17 cases of inpatients with pulmonary aspergillosis fumigatus during June 2008 to December 2010 was carried out.Results The morbidity of pulmonary aspergillosis fumigatus was increased,it mostly occurred in patients with low immune function,older persons and long-term application of antibiotics,glucocorticoid and immunosuppressive agents and multiple basic diseases,their mortality was high.Their main clinical symptoms were long-term high fever,dyspnea,coughing with mucus sputa,hemoptysis etc.High fever and hemoptysis were frequently seen in these patients.CT scanning may manifest as ＂halo＂ sign.Conclusion Clinical characteristics of pulmonary aspergillosis are lack of specificity with poor outcome.It should be early diagnosed and administrated with antifungal drugs in full dosage and course,and voriconazole,caspofungin,itraconazole and amphotericin B liposome etc may be selected for application in its treatment.