29例不同免疫状态肺隐球菌病临床分析

目的分析不同免疫状态肺隐球菌病的临床表现、治疗。方法回顾性分析2004年1月至2011年5月我院确诊为肺隐球菌病患者的临床资料。结果确诊肺隐球菌病共29例,免疫低下组9例,免疫正常组20例。免疫低下组仅3例(33.3%)无症状,而免疫正常组有12例(60%)无症状。免疫低下组有6例(66.7%)累及双肺,而免疫正常组仅6例(30%)累及双肺。两组病例共随诊22例,均未发生隐球菌全身播散。结论肺隐球菌病起病隐匿,临床及影像学不特异,诊断主要依赖病原学及病理检查。治疗应根据不同患者的免疫状态采取合理的方法,免疫功能正常的患者预后较好。

Clinical analysis of pulmonary cryptococci infection in 29 patients under different immune states

Objective To analyze the clinical manifestations and treatment of pulmonary cryptococcosis in patients under different immune states.Methods Retrospective analysis was performed on the clinical data in patients with physician-diagnosed pulmonary cryptococcosis in my hospital from Jan 2004 to May 2011.Results 29 patients had a confirmed diagnosis,of whom 9 were immunocompromised and 20 were immunocompetent.There were 3 patients(33.3%) who remained asymptomatic in immunocompromised group,while there were 12 patients(60%) in immunocompetent group.There were 6 patients(66.7%) involving bilateral pulmonary in immunocompromised group,while only 6 patients(30%) in immunocompetent group.There were 22 patients being followed up in the both group.None of them had more advanced cryptococcal infections disseminating all through the body.Conclusion The pathogenesis of pulmonary cryptococcosis was proved to be insidious due to its nonspecifle clinical and radiographic characteristics,and the diagnosis depended on pathogenic and pathologic examinations.More reasonable treatments of pulmonary cryptococcosis should be adopted according to patients immune states,and better prognosis seemed to be in favor of immunocompetent subjects.