非HIV感染免疫损害宿主肺部感染51例临床分析

目的 探讨非人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染免疫损害宿主(immunocompromised host,ICH)肺部感染的早期病原学诊断和治疗方法.方法 对51例非HIV感染ICH肺部感染患者临床资料进行回顾性分析.结果 主要临床表现为发热、咳嗽、呼吸困难.多数患者(28例,54.9%)X线胸片或胸部CT表现为双肺受累,10例(19.6%)提示双肺间质性改变.24例(47.1%)检出病原体,其中13例(54.2%)为混合感染,细菌(14例)主要为绿脓杆菌和肺炎克雷白杆菌,结核杆菌4例;真菌(11例)主要为白色念珠菌和假丝酵母菌;病毒(10例)为巨细胞病毒.经治疗,存活45例(88.2%),死亡4例(7.8%).结论 非HIV感染ICH肺部感染临床表现无特异性,肺高分辨CT和纤维支气管镜检查等有助于提高诊断率,早期作出可靠的病原学诊断、及时而有效的综合治疗可提高其治愈率.

Clinical analysis of non-HIV immunocompromised 51 patients with pulmonary infections SUN Ji-ping,

Objective To explore the early etiological diagnosis and therapeutics of non-HIV immunocompromised patients with pulmonary infections. Methods A retrospective analysis was made on the clinical data of 51 pulmonary infection cases with non-HIV immunocompromised patients. Results Fever,cough and anhelation were the most common initial symptoms. Ten patients (19.6%) showed pulmonary interstitial changes. Microorganisms were detected in 24 cases (47.1%). 54.2%(13/24) of the patients were caused by mixed infections. Bacteria (14 cases) were mainly Pseudomonas and Klebsiella friedlanderi;Mycobacterium tuberculosis (4 cases); Fungus (11 cases) were mainly Candida albians and Fermentum;Cytomegalovirus (10 cases). The treatments were effective in 45 cases (88.2%),mortality rate was 7.8%(4/51). Conclusions Nonspecific constitutional symptoms may occur in the cases. Early diagnosis with application of high-resolution CT and bronchofiberoseopy should be emphasized. Specially stress lies in the importance of making early etiological diagnosis and providing combined therapy for the patients.