共查询到18条相似文献,搜索用时 62 毫秒
1.
2.
3.
卡氏肺囊虫肺炎临床诊治的初步体会 总被引:19,自引:0,他引:19
目的提高对卡氏肺囊虫肺炎(PCP)的认识。方法回顾性分析6例PCP患者资料。结果6例PCP基础疾病为白血病、淋巴瘤、肾移植和溶血性贫血。临床表现为呼吸困难、咳嗽和发热。X线表现为双肺弥漫性肺泡性或间质性改变或无改变。治疗首选复方新诺明(SMZco)和氨苯砜。3例并发呼吸衰竭,表现与成人呼吸窘迫综合征(ARDS)相似的低氧血症、肺内分流和顺应性下降。持续气道正压通气/呼气末正压通气(CPAP/PEEP)为常用模式。顽固性低氧血症可试用高水平(>147kPa)PEEP治疗。结论卡氏肺囊虫肺炎并发急性呼吸衰竭者预后差,争取早期诊断与治疗是提高生存率的关键。 相似文献
4.
5.
6.
卡氏肺囊虫基因分型方法的应用研究进展 总被引:2,自引:1,他引:1
卡氏肺囊虫(Pneumocystiscarinii,Pc)于1988年被证明是一种真菌,主要引起免疫妥协患者,特别是感染HIV的AIDS患者的卡氏肺囊虫肺炎(PcP)。在临床和流行病学研究中,传统的表型分型方法,如用特异抗血清仅能区分来自不同宿主及不同地理区域的Pc,不能进行株鉴定,难以满足实际需要[1~3];现代的基因分型方法,因其分辨力和分型率高而倍受重视。由于感染人类的Pc尚不能人工培养,RFLP[4]、PFGE[5]等需用大量病原体的分型方法并不适合临床及环境样本中微量Pc的分析。因此,… 相似文献
7.
8.
目的探讨艾滋病患者继发卡氏肺囊虫肺炎影像学的表现。方法回顾性分析2009-01~2011-12经临床确诊为艾滋病合并卡氏肺囊虫肺炎28例患者的影像学表现。结果典型的肺部影像学表现为双侧肺野弥漫性渗出性病变分布于肺门两侧周围肺野,病灶呈磨砂玻璃状、网格状、地图样或碎石路征。结论胸部X线片及CT扫描对艾滋病继发卡氏肺囊虫肺炎有重要诊断价值。 相似文献
9.
肾移植术后并发卡氏肺囊虫性肺炎的护理 总被引:1,自引:0,他引:1
肾移植术后患者为了达到抑制排异反应 ,维持移植功能的目的 ,需长期服用免疫抑制剂 ,但由于机体的免疫系统受到损害 ,时时处于一个被抑制的非常低下的免疫功能状态 ,对各种病原体易感性大大增加 ,且一旦感染其危险程度也非同一般患者 ,影响患者的预后。卡氏肺囊虫性肺炎 (PCP)即是其中之一。PCP大多发生在移植术后 1- 6月 ,起病隐匿 ,症状逐渐出现 ,最常见的是发热、咳嗽和气促。治疗不及时者 ,气促、呼吸困难逐渐加重 ,可在数周至 2个月内发展为呼吸衰竭而死亡 ,病死率很高 ,几乎达 10 0 % [1 ] 。我科近半年多来收治的 PCP患者大多临… 相似文献
10.
复方新诺明预防HIV感染患儿卡氏肺囊虫肺炎(附46例分析) 总被引:2,自引:0,他引:2
陈赛斌 《中国人兽共患病杂志》1999,16(5):116-116
卡氏肺囊虫肺炎(PCP)是儿童艾滋病早期死亡的主要原因。预防卡氏肺囊虫肺炎对于延长艾滋病患儿的生存期至关重要。本文总结46例人类免疫缺陷病毒(HIV)感染患儿使用复方新诺明(SMZco)预防卡氏肺囊虫肺炎,现报告如下。1 资料及方法11 临床资料 本文46例为南部非洲博茨瓦纳国家Nyangabywe医院小儿内科1993年6月~1994年6月经过HIV抗体酶联免疫吸附法(EILSA)与免疫印迹(WB)检测阳性而确诊的HIV感染患儿。男24例,女22例,年龄最小4个月,最大5岁,2岁以内患儿占60… 相似文献
11.
Three proven cases and one presumed case of Pneumocystis carinii pneumonia are presented in which the radiological appearance mimics tuberculosis. The classic and unusual X-ray findings of P. carinii pneumonia are discussed. 相似文献
12.
卡氏肺孢子虫肺炎肺灌洗液细胞和生化成分变化的研究 总被引:5,自引:0,他引:5
目的 研究卡氏肺孢子虫肺炎(PCR)支气管肺泡灌洗液(BALF)中细胞和生化成分的变化及与细菌性肺炎的差别。方法 采用清洁级Sprague-Dawley大鼠50只,每周2次皮下注射泼尼松建立PCP模型(14只),阴性对照组(6只),细菌性肺炎组(11只)为实验组,并设正常对照组(6只)。 相似文献
13.
14.
目的:讨论肾移植术后并发卡氏肺孢子虫肺炎(PCP)的早期诊断和治疗。方法:对6例肾移植术后并发PCP患者的临床资料进行分析和总结。结果:6例患者经支气管镜肺泡穿刺活检和支气管肺泡灌洗确诊。PCP发病于术后95~172d,一经确诊,根据肾功能及耐受情况予以复方新诺明[SMZco(SMZ50~70mg/(kg.d)TMP10~14mg/(kg.d)治疗3周,同时根据患者外周血CD4+计数及CD4+/CD8+比值调整免疫抑制方案,6例患者均治愈。结论:PCP确诊有赖于肺组织活检或肺泡灌洗找到病原体,必要时诊断性治疗不失为有效方法。治疗首选SMZco,但剂量应结合患者肾功能和耐受情况,并根据患者免疫状态调整免疫抑制方案。 相似文献
15.
16.
Saito T Seo S Kanda Y Shoji N Ogasawara T Murakami J Tanosaki R Tobinai K Takaue Y Mineishi S 《American journal of hematology》2001,67(3):206-209
Pneumocystis carinii (P. carinii) is one of the major opportunistic pathogens responsible for hematopoietic stem cell transplantation (HSCT)-related pneumonias. Although trimethoprim-sulfamethoxazol (TMP/SMX) prophylaxis has been shown to prevent almost all P. carinii infections, 1%-2% of patients may still experience this complication. P. carinii pneumonia (PCP) is usually a late complication in patients receiving TMP/SMX prophylaxis, with most cases occurring later than 2 months post-transplant. We report a patient who developed early onset PCP after allogeneic peripheral blood stem cell transplantation (PBSCT) from an HLA-identical sibling donor. On day 12, the patient complained of dyspnea and cough. A chest X ray showed infiltrates in right upper lobe with bilateral pleural effusion. By the findings of Grocott stain on bronchoalveolar lavage fluid obtained on day 14, he was diagnosed as having PCP. Intravenous TMP/SMX failed to improve the lesion. This is the earliest onset PCP in the literature after HSCT despite the prophylactic administration of TMP/SMX before transplant. 相似文献
17.
A. Tomonari S. Takahashi J. Ooi N. Tsukada T. Konuma S. Kato S. Kasahara T. Iseki A. Tojo S. Asano 《Transplant infectious disease》2008,10(5):303-307
Abstract: The incidence of pneumonia caused by Pneumocystis carinii (PCP) (organism now renamed Pneumocystis jiroveci) during the early period after cord blood transplantation (CBT) was studied in 120 adults. Initially 89 patients (74%) received oral administration of 2 single‐strength trimethoprim‐sulfamethoxazole (TMP‐SMZ) tablets twice daily from day ?21. In 45 of 89 patients (51%), TMP‐SMZ administration for a scheduled duration was completed. In the remaining 44 patients (49%), however, TMP‐SMZ administration was discontinued prior to day ?3 because of toxicity. Among these patients, 42 subsequently received aerosolized pentamidine (AP) on a median of day ?13 (range, ?20 to ?6). Thirty‐one patients (26%) received AP without TMP‐SMZ administration on a median of day ?14 (range, ?21 to ?9). None of the 120 patients were diagnosed with PCP within 100 days or 2 years after CBT; however, one patient who received AP before CBT but no prophylaxis after CBT developed cerebral toxoplasmosis on day +91. Pre‐transplant prophylaxis against PCP did not significantly affect transplantation‐related mortality or disease‐free survival at 2 years after CBT. The results suggest that PCP during the early period after CBT can be effectively prevented by any pre‐transplant prophylactic method. 相似文献