卡泊芬净治疗非HIV感染患者肺孢子菌肺炎所致重症急性呼吸窘迫综合征效果探讨

Caspofungin as a preemptive therapy for severe acute respiratory distress syndrome caused by severe pneumocystis pneumonia in non-HIV infected patients

目的:探讨卡泊芬净治疗非HIV感染宿主肺孢子菌肺炎所致重症急性呼吸窘迫综合征时的价值。方法:通过分析2例卡泊芬净成功治疗非HIV感染宿主因重症肺孢子菌肺炎所致重症急性呼吸窘迫综合征的疗效,总结非HIV感染宿主肺孢子菌肺炎的临床特点,并结合相关文献进行讨论。结果:2例患者临床表现为干咳、发热、呼吸困难,临床呈重度急性呼吸窘迫综合征进程,需要呼吸机辅助呼吸,影像学表现为双肺弥漫分布膜玻璃影,小叶间隔增厚,G试验高滴度阳性,根据这些特点给予卡泊芬净抢先治疗,患者临床症状改善很快,最终康复出院。结论:卡泊芬净可以作为非HIV感染宿主肺孢子菌肺炎所致重症急性呼吸窘迫综合征的抢先治疗方案。

Objective： To investigate the value of caspofungin as preemptive therapy in the treatment of severe acute respiratory distress syndrome caused by pneumocystis pneumonia in non-HIV infected patients. Methods： The clinical features of two cases of severe acute respiratory distress syndrome in non-HIV infection patients caused by severe pneumocystis pneumonia which were successfully treated with caspofungin were analyzed and related literature was reviewed. Results： The clinical manifestations of the patients included cough, high fever, and dyspnea, and the clinical process was severe acute respiratory distress syndrome. They both needed mechanical ventilation and the imaging showed diffused distribution of ground-glass shadow and interlobular septa thickening. The G titer was high. According to the characteristics, preemptive therapy with caspofungin was given. The clinical symptoms of the patients improved quickly and the patients were eventually discharged. Conclusion： Caspofungin can be used as a preemptive therapy for severe acute respiratory distress syndrome caused by severe pneumocystis pneumoniae in patients of non-HIV infection.