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肺孢子菌肺炎诊治的研究进展 被引量:17

Research progress in the diagnosis and treatment of Pneumocystis pneumonia
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摘要 目的综述肺孢子菌肺炎(PCP)病原诊断和治疗的研究进展。方法通过文献检索和分析,总结PCP诊治研究进展。结果 PCP的临床诊断主要依据患者存在免疫缺陷或免疫功能低下的基础状况以及典型临床和影像学表现来进行,确诊有赖于病原学检查。近年来研究表明PCR技术和血清1,3-β-D葡聚糖检测(G试验)有助于PCP早期诊断以及区分肺孢子菌定植和感染。复方磺胺甲噁唑(SMZco)是治疗PCP的首选用药,卡泊芬净近年来也联合应用于PCP的治疗,但其应用价值仍待进一步研究。结论 PCP的诊断仍以临床诊断为主,治疗上仍以SMZco为首选,探索PCP早期诊断技术和提高重症患者救治成功率是今后研究的重点。 Objective To review the progress in the diagnosis and treatment of Pneumocystis pneumoniae (PCP). Methods The progress of PCP diagnosis and treatment was summarized by literature retrieving and analyzing literature. Results The clinical diagnosis of PCP is mainly based on the basic condition of immunodeficiency or immune suppression, and typical clinical and imaging manifestations, and the definite diagnosis depends on etiological examination. In recent years, many studies have shown that PCR and serum (1,3)-beta-D-glucan assay are helpful to the early diagnosis of PCP and to distinguish colonization and infection of Pneumocystis . Compound sulfamethoxazole (SMZco) is the preferred drug for the treatment of PCP, in addition, caspofungin was combined with SMZco to treat PCP in recent years, but its value in PCP treatment remains to be further studied. Conclusion The diagnosis of PCP mainly depends on clinical presentations. SMZco is the first choice for PCP treatment. Exploring the early diagnosis technology of PCP and improving the success rate of critical cases is the focus of future research.
作者 何小清 沈银忠 HE Xiao-qing;SHEN Yin-zhong(Shanghai Public Health Clinical Center,Fudan University,Shanghai 201508)
出处 《中国真菌学杂志》 CSCD 2018年第4期247-251,共5页 Chinese Journal of Mycology
基金 上海市科委医学引导类科技支撑项目(17411969600) 中国博士后科学基金(2014M560869) 国家十三五传染病重大专项(2017ZX10202101)
关键词 肺孢子菌肺炎 诊断 治疗 Pneumocystis pneumonia diagnosis treatment
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