肺隐球菌病35例临床分析

Clinical analysis of 35 cases of pulmonary cryptococcosis

目的探讨肺隐球菌病的临床特点,提高医务人员对肺隐球菌病的临床诊疗能力。方法回顾性分析东莞市人民医院35例确诊为肺隐球菌病患者的临床症状、胸部影像和治疗情况。结果 35例肺隐球菌患者中,19例(54.3%)无明显基础疾病;29例(82.9%)的临床症状主要表现为咳嗽、咳痰等;影像学表现为肺单发或多发结节肿块影(11例,31.4%),或渗出实变影(12例,34.3%),或两种病灶混合存在(12例,34.3%);19例患者红细胞沉降率升高;13例患者白细胞轻度增高;2例患者无法判断疗效,其余病情均有好转。结论肺隐球菌病的临床症状与影像学表现无特征性,确诊需依靠病理活检,经皮肺穿刺活检是有效的诊断手段。

Objective To investigate the clinical features of pulmonary cryptococcosis in order to improve the diagnosisand treatment of medical staffs. Methods Thirty-five patients diagnosed as pulmonary cryptococcosis admitted in DongguanPeople＇s Hospital were recruited in this study. The clinical manifestations,chest imaging features,and treatment wereretrospectively analyzed. Results Among those 35 patients,19（54.3%）had no significant underlying diseases,and 29（82.9%）were with the main manifestations of cough/expectoration. The common patterns of computed tomography（CT）scannig were nodules and masses,either solitary or multiple（11,31.4%）,infiltration and consolidation（12,34.3%）,or mixedlesions（12,34.3%）. Nineteen patients had elevated erythrocyte sedimentation rate,and 13 lightly increased WBC count.Besides 2 patients were unable to evaluate the curative effect,and the others were improved. Conclusion The clinicalmanifestations and imaging findings of pulmonary cryptococcosis are not characteristic. So,the diagnosis is mainly dependenton pathology,and percutaneous lung biopsy is an effective diagnostic method.