非粒缺患者侵袭性肺真菌病诊疗思路

Ideas for diagnosis and treatment of invasive pulmonary fungal diseases in patients with non-granulocytosis

真菌感染已经成为对公共卫生构成最大威胁的感染性疾病,尤其是侵袭性真菌病。免疫缺陷有无及程度与真菌感染的类型与轻重密切相关,也决定了侵袭性真菌病的临床表现、影像学改变、诊断与治疗的差异,只有掌握这些异同,才能准确诊断与正确治疗。本文从非粒细胞缺乏(非粒缺)患者罹患侵袭性肺真菌病时发病机制、诊断标准、临床表现和影像学改变、诊断技术以及治疗方案的不同,分析其诊疗思路应有的差异。

Fungal infection has become the greatest threat to public health,especially invasive fungal diseases(IFDs).The degree of immunodeficiency is closely related to the type and severity of fungal infection,and also determines the clinical manifestations,imaging changes,diagnosis and treatment of IFDs.Only by mastering these similarities and differences can we make accurate diagnosis and correct treatment.This paper analyzes the differences in diagnosis and treatment of non-granulocytopenia patients with pulmonary IFDs from the aspects of pathogenesis,diagnostic criteria,clinical manifestations and imaging changes,diagnostic techniques and treatment plans.