淋巴瘤化疗后肺部侵袭性真菌感染的临床分析

Clinical Analysis of Invasive Pulmonary Fungal Infection in Patients with Lymphoma

目的探讨淋巴瘤化疗后肺部侵袭性真菌感染(IPFI)的临床特点。方法回顾性分析收治的24例淋巴瘤患者的临床资料。结果24例患者化疗后出现肺部侵袭性真菌感染,其中确诊1例,临床诊断7例,拟诊16例,发病率为3.4%;病原菌以曲霉菌多见;CT影像表现复杂多样,以双肺受累、结节影、团块状高密度影多见;所有患者均出现血饱和度下降;一线抗真菌治疗后20例缓解,有效率为83.3%。结论淋巴瘤化疗后肺部侵袭性真菌感染的发病率较高,临床表现不典型,进展快,高分辨胸部CT有助于早期诊断,早期经验治疗有助于改善预后。

Objective To summarize the clinical features of invasive pulmonary fungal infection(IPFI)in patients with lymphoma after chemotherapy.Methods We retrospectively analyzed the clinical data of 24 patients with lymphoma.Results 24 patients(3.4%)developed IPFI after chemotherapy,including 1 case,7 cases,and 16 cases considered as proven,probable,and possible,respectively.Aspergillus were the most common fungal pathogens.The CT imaging findings were complicated and diverse,in which the double lungs involvement,nodular shadows and crumb of high-density shadows were common.All patients demonstrated a decrease in the saturation of blood oxygen level.20 cases relieved after first-line antifungal therapy and the total effective rate was 83.3%.Conclusion The result shows a high incidence of IPFI secondary to lymphoma.The disease lacks typical clinical manifestations and tends to progress rapidly,high-resolution CT can help to early diagnosis.Early empirical antifungal therapy can improve prognosis.