老年2型糖尿病合并侵袭性肺曲霉菌病误诊2例报告并文献复习  

Elderly Type 2 Diabetes Mellitns and Invasive Pulmonary Aspergillosis:Two Misdiagnosed Cases Report and Literature Review

作　　者：白晓宁[1] 侯敏全[1] 王惠芳[1] 

机构地区：[1]西安交通大学医学院第一附属医院老年内科,710061

出　　处：《临床肺科杂志》2009年第1期26-28,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的讨论侵袭性肺曲霉菌病的临床特征、诊断、治疗方法以及在老年2型糖尿病患者中发病的原因分析。方法报告2例老年2型糖尿病患者合并侵袭性肺曲霉菌病的误诊病例,同时进行相关文献复习。结果2型糖尿病作为慢性基础疾病是发生侵袭性肺曲霉菌病的危险因素。侵袭性肺曲霉菌病临床诊断应综合症状、实验室和影像学检查,确诊依靠病理结果。结论老年2型糖尿病患者若出现难以治愈的肺部感染,应想到侵袭性肺曲霉菌病的可能。侵袭性肺曲霉菌病死亡率高,应在有效地控制患者血糖指标和相关并发症的同时,积极抗真菌治疗,对于老年人必要时应用胸腺肽增强免疫力提高治疗效果。Objective To investigate clinical feature and methods of diagnosis and treatment in invasive pulmonary aspergillosis （ IPA）, to analyze the etiology of IPA in elderly patients with type 2 diabetes mellitus. Methods The clinical data of 2 cases of elderly type 2 diabetes mellitns and IPA. And the related articles were reviewed. Results Type 2 diabetes mellitus is a risk factor for IPA as a basic chronic disease. To make a clinical diagnosis after studying patient＇s symptoms, laboratory tests and imaging examination synthetically, to make a accurate diagnosis by pathological report. Conclusions When pulmonary infection isn＇t controlled easily in elderly patients with type 2 diabetes mellitus, we must think probability that the patients suffer from IPA. The disease has a highest mortality. While controlling blood sugar levels or complication, the patients are aggressively treated with antifungal agents, to use thymosin in order to improving immunity in elderly patients when necessary.

关 键 词：侵袭性肺曲霉菌病/诊断 误诊 老年人 糖尿病 

分 类 号：R587.1[医药卫生—内分泌] R519[医药卫生—内科学]