艾滋病患者并发卡氏肺囊虫肺炎临床诊治体会

The Clinical Diagnosis and Treatment Experience of AIDS Patient with Concurrent Pneumocystis Carinii Pneumonia

目的:探讨艾滋病患者并发卡氏肺囊虫肺炎的临床诊治体会。方法:回顾性分析2012年6月—2013年10月期间我院因发生卡氏肺囊虫肺炎需治疗艾滋病患者40例,按计划分为2组,每组20例,分别予以综合治疗(观察组)和仅服用复方新诺明(对照组),观察所有患者入院后病情发生临床表现,并比较两组患者治疗后病情发展转归情况。结果:所有患者均出现发热、咳嗽症状,CT示云雾样、磨玻璃状影;观察组发生心力衰竭12.5%,明显低于对照组15%,低氧血症改善5.5±1.5d,明显少于对照组10.5±3.5d,治愈率22.5%,明显高于对照组10%,住院时间13±4.5d,明显少于对照组21±5.5d。结论:艾滋病患者并发卡氏肺囊虫肺炎起病临床表现无特异性,需结合X线和CT进一步确诊,治疗上以综合治疗效果更好,不建议单独用药治疗。

Objective： To discuss the clinical diagnosis and treatment experience of AIDS patient with concurrent Pneumocystis carinii pneumonia. Methods： Analyze retrospectively the 40 AIDS patients needed treatment because of Pneumocystis carinii pneumonia during June, 2012 to October,2013, divided into two groups as planned , twenty each group , giving comprehensive therapy（ observation group） and only taking cotrimoxazole （control group）, observing all the patients＇ clinical manifestation of the state of illness after being in hospital ,comparing the disease outcome of the two group patients after therapy. Results：All the patients have the symptom of fever,cough, CT shows cloud ,grinding glassy shadow;The cardiac failure of the observation group occurs at 12.5%, obviously lower than the control group, 15%, the improvement of hyoxemia is 5.5 ±1.5d, obviously less than control group, 10.5 ± 3.5d, cure rate, 22.5%, obviously higher than control group, 10%, hospital stays, 13 ± 4.5d, obviously less than contM group, 21 ＋ 5.5d. Conclusion： The onset of AIDS patient with concurrent Pneumocystis carinii pneumonia has no specificity in clinical manifestation, needing further and definite diagnosis combined with X-ray and CT, the effect is better in the form of comprehensive treatment, treating with drugs alone is not suggesting.