侵袭性肺曲菌病16例临床分析

Clinical analysis of 16 cases of invasive pulmonary aspergillosis

目的:总结侵袭性肺曲菌病(IPA)的临床特点。方法:对2010年1月至2012年7月间在我院呼吸科诊断为IPA的患者的危险因素、临床特征、治疗与转归进行回顾性分析。结果:16例IPA患者中15例合并有基础疾病,主要为慢性阻塞性肺疾病、糖尿病及恶性肿瘤放化疗。临床表现主要为发热、咯血、呼吸困难、咳嗽咳痰,影像学多表现为单发或多发结节影或实变影,有2例出现空洞。所有病例均接受抗真菌治疗,13例痊愈。结论:IPA临床症状和影像学表现不典型,病死率高,对临床诊断病例应尽早治疗,从而改善预后。

Objective： To investigate the clinical characteristics of invasive pulmonary aspergillosis. Methods：The clinical data of 16 patients with IPA from January 2010 to July 2012 in our respiratory medicine department were retrospectively analyzed. Results： Among 16 patients with IPA, 15 cases have basic disease. Chronic obstructive pulmonary disease, diabetes mellitus, radiotherapy and chemotherapy of malignant tumor were the main basis of IPA. The clinical symptoms mostly presented as fever, emptysis, dyspnea and cough. CT features included single or multiple nodules, consolidations, and cavities were found in 2 patients. Every patient received antifungal therapies, 13 patients were recurred. Conclusion： The clinical symptoms and imaging feature for invasive pulmonary aspergillosis are non-specific, and with a high mortality rate. Early diagnosis and reasonable treatments for IPA could remarkably improve the prognosis of IPA.