摘要
目的探讨非免疫缺陷者肺曲霉病的临床多样性,为临床早期诊断提供帮助。方法通过检索PubMed,中国知网中国期刊全文数据库(CNKI),万方数据库,维普期刊数据库及中国生物医学文献光盘数据库(CBMdisc)等数据库,搜集临床资料较完整的确诊为非免疫缺陷者肺曲霉病病例。结果对19例经肺组织病理学和(或)微生物学证据确诊为非免疫缺陷者肺曲霉病文献进行复习。19例非免疫缺陷者肺曲霉病患者中,从事可能暴露曲霉的高危职业包括房屋修建、清仓搬家工作及木工等5例(26.3%),农民1例(5.3%),粮仓仓库保管员1例(5.3%)。临床症状主要表现为咳嗽(78.9%),发热(63.2%),咯痰(63.2%),呼吸困难(57.9%),喘息(26.3%),胸闷(26.3%),胸痛(26.3%),咯血(26.3%),流感样症状(10.5%)。在行胸部CT检查的10例中,主要表现为双肺弥漫性浸润、多发结节影7例,其中伴有晕轮征3例,空洞4例;1例为双肺间质浸润;2例表现为肿块影。随着病情进展,可表现为结节影增多、融合,肺叶实变及多发空洞形成,且变化迅速。结论非免疫缺陷者肺曲霉病临床和影像学所表现的曲霉变应性和侵袭性所致的多样性有助于早期诊断。
Objective To describe the clinical picture of pulmonary aspergillosis in non-immunocompromised host for early recognition of the disease. Methods Major electronic databases, such as Pubmed, CNKI, Wanfang database, VIP database, and CBMdisc, were searched to identify the reported cases of pulmonary aspergillosis in non-immunocompromised host. The clinical data of these paients were reviewed and analyzed. Results Nineteen histologically and/or microbiologically confirmed cases of pulmonary aspergillosis in non-immunoeompromised host were identified and included in this analysis. Patients at high risk of Aspergillus spp. exposure included builders (5, 26.3%), peasant (1, 5.3%) and granary storekeeper (1, 5.3%). The main symptoms were cough (78.9%), fever (63.2%), sputum (63.2%), dyspnea (57.9%), wheeze (26.3%), chest tightness (26.3%), chest pain (26. 3%), hemoptysis (26.3%), and influenza-like symptoms (10. 5%). Chest CT scan in 10 cases showed bilateral diffuse infiltration and nodules in 7 cases, bilateral pulmonary interstitial infiltration in 1 case, mass shadow in 2 cases. As the condition got worse, chest CT revealed rapidly changing pictures including increased number of nodules and tendency lowards confusion, lobar consolidation, and multiple cavities. Conclusions The clinical and imaging diversity of pulmonary aspergillosis in immunocompromised host, which is attributed to the allergenicity and invasiveness of Aspergillus spp, may be helpful for early identification of the disease.
出处
《中国感染与化疗杂志》
CAS
北大核心
2013年第3期181-184,共4页
Chinese Journal of Infection and Chemotherapy
关键词
非免疫缺陷
肺曲霉病
临床特征
non immunocompromised
pulmonary aspergillosis
clinical characteristic