艾滋病合并巨细胞病毒性肺炎的临床特点和治疗

目的 探讨艾滋病合并巨细胞病毒性(CMV)肺炎的临床特点和治疗方法.方法 分析2008年1月～2010年12月艾滋病合并巨细胞病毒性肺炎10例患者的临床资料,对艾滋病合并巨细胞病毒性肺炎的临床特点和治疗方法进行总结.结果 在10例患者中,CMV肺炎的症状明显早于体征,患者均出现发热,同时伴有咳嗽、气促、呼吸困难等临床表现；血氧饱和度降低,血气分析提示低氧血症；血CMV-IGM及CMV-DNA检测均为阳性.采用更昔洛韦联合膦甲酸钠抗病毒治疗,同时采取HAART、加用较大剂量的甲强龙或丙种球蛋白和适量的胸腺肽等的个体化免疫调节方案等综合治疗方法,5例治愈,治愈率为50％.2例患者死于呼吸衰竭.结论 艾滋病合并CMV肺炎临床特点以发热、咳嗽为主,病情迅速发展出现高热、呼吸困难、低氧血症以及呼吸窘迫综合征,治疗不及时死亡率高.

The clinical features and treatment of AIDS combined with Cytomegaloviral pneumonia

Objective To explore the clinical features and treatment of AIDS combined with cytomegaloviral pneumonia.Methods The clinical data of 10 patients with AIDS combined with cytomegaloviral pneumonia were retrospectively analysed from January 2008 to December 2010,and the clinical characteristics and treatment method were summarized.Results In the 10 patients,the symptoms of CMV pneumonia were before signs.The clinical manifestations were fever,cough,and dyspnea.Oxygen saturation decreased,which suggested hyoxemia.Blood CMV-IGM and CMV-DNA testing were all positive.Using the individual immune adjustment scheme of comprehensive treatment,such as ganciclovir for injection,foscarnet sodium injection,HAART,combined with large doses of sou-medrol andr-globulin,thymopeptides,5 cases were cured,and the cure rate was 50%.2 cases were died of respiratory failure.Conclusions The clinical features of AIDS combined with cytomegaloviral pneumonia are primarily fever and cough.Typerpyrexia,difficulty breathing,hyoxemia and acute respiratory distress syndrome appear with rapid development.Lack of timely treatment will lead to a high mortality rate.