肾病综合征合并卡氏肺孢子菌肺炎3例报告并文献复习

目的分析肾病综合征合并卡氏肺孢子菌肺炎（PCP）的临床和影像学表现。方法对3例肾病综合征合并PCP患者的临床资料进行分析，并进行相关文献复习。结果3例皆以发热、咳嗽、进行性呼吸困难为首发症状，影像学表现为双肺弥漫性磨玻璃影；2例合并呼吸衰竭；3例均痰中找到卡氏肺孢子菌；治疗药物包括复方磺胺甲嗯唑，克林霉素及卡泊芬净；2例治愈，1例死亡。结论肾病综合征合并PCP时，有典型的临床和影像学表现；肾病综合征患者免疫抑制治疗后出现进行性低氧血症应考虑PCP的可能性，需早期诊断、早期治疗。

Reports and documents review of 3 cases of nephrotic syndrome(NS) complicated with pneumocystis carinii pneumonia(PCP)

Objective To analyze the clinical manifestations and imaging findings of nephrotic syndrome （NS） complicated with pneumoeystis carinii pneumonia （PCP）. Methods The clinical data of 3 patients with NS complicated with PCP were retrospectively analyzed and the pertinent literatures were reviewed. Results The first symptoms of the 3 patients were fever, cough, and progressive dyspnea, and their image showed diffusivity ground - glass opacity in double lungs. 2 cases were complicated with respiratory failure and pneumocystis carinii were found in the sputum of 3 cases. The therapeutic drugs included sulfamethoxazole, clindamyein and caspofungin. 2 cases were cured and 1 case reported dead. Conclusion Nephrotic syndrome complicated with PCP has typical symptoms and imaging findings. The possibility of PCP should be considered when the progressive bypoxemia is presented in patients with NS who are treated with immunosuppressive drugs.