2型糖尿病合并侵袭性肺曲霉菌病10例临床分析

The clinical analysis of 10 cases of type 2 diabetes mellitus combined with invasive pulmonary aspergillosis

目的:探讨2型糖尿病合并侵袭性肺曲霉菌病(IPA)的临床特点,提高临床医师对该病的诊治水平。方法:回顾性分析2007年12月至2012年11月浙江省富阳市人民医院收治的10例2型糖尿病合并侵袭性肺曲霉菌病患者的临床资料。结果:10例侵袭性肺曲霉病患者均有2型糖尿病病史,确诊3例,临床诊断7例,临床表现以咳嗽咳痰为主,肺CT表现结节影伴晕轮征或新月征为主,予以抗真菌治疗后,6例有效,1例自动出院,3例死亡。结论:2型糖尿病是发生侵袭性肺曲霉菌病的危险因素,临床表现缺乏特异性,结合相关糖尿病病史及影像学检查,有助于早期诊断和治疗,改善预后。

[ Objective] To analyze the clinical characteristics in Type 2 diabetes combined with invasive pulmonary aspergillosis （IPA） to raise the ability of clinical doctors on diagnosis and treatment of the disease. [Method] Clinical data of 10 cases with type 2 diabetes and invasive pulmonary aspergillosis enrolled in Zhejiang fuyang people＇s hospital from Dec 2007 to Nov 2012 were retrospective analyzed. [Result] The 10 IPA patients including 3 ＂proven＂ and 7 ＂probable＂ cases, with the history of type 2 diabetes, had cough and expectoration, and the CT manifestations showed pulmonary nodules with halo sign or crescent sign. They were treated with antifungal, Antifungal was effective in 6 cases. 1 Patient was being discharged from the hospital and 3 cases died. [ Conclusion] Type 2 diabetes is a risk factor for invasive pulmonary aspergillosis. Anfifungal treatment for patient who is lack of clinical manifestations, combining with related diabetes history and imageological examination, is helpful to early diagnosis and treatment and can improve the prognosis.