15例肺曲霉菌病临床研究  

Clinical analysis of 15 patients with pulmonary aspergillosis

作　　者：梁丽萍[1] 左万里[1] 周燕斌[1] 胡少华[1] 

机构地区：[1]江门市中心医院,529000

出　　处：《中国实用医药》2011年第7期7-9,共3页China Practical Medicine

摘　　要：目的探讨肺曲霉菌病的临床表现、影像学特点及诊断治疗。方法回顾分析2004年1月至2010年12月广东江门市中心医院诊断为肺曲霉菌病的住院患者共15例,总结其临床表现、影像学特点、诊断及治疗情况。结果 15例患者均在原发病的基础上合并感染,其中侵袭性肺曲霉菌病10例,曲菌球菌病4例,变态反应性支气管肺曲霉菌病1例。主要症状为咳嗽、咳痰、发热、气促和咯血。胸部CT病灶形态可为实变、淡薄影、多形性变,部分出现肺门、纵膈淋巴结肿大及胸腔积液。12例(12/15)初诊误诊,8例(8/15)通过肺组织发现曲霉菌丝或曲霉菌的培养确诊。10例(10/15)患者治愈或好转。结论肺曲霉菌病多继发于全身基础疾病;临床表现特异性低,影像学表现多样。提高早期确诊率、恰当治疗可提高疾病预后。Objective To explore the clinical manifestations,imaging features,diagnosis and managements of pulmonary aspergillosis（PA）.Methods 15 patients with PA admitted to Jiangmen Central hospital from January 2004 to December 2010 were reviewed retrospectively.Clinical manifestations,imaging features,diagnostic methods and managements were analyzed.Results 10 cases were invasive pulmonary aspergillosis,4 cases were aspergilloma and 1 case was allergic bronchopulmonary aspergillosis.All of these had underlying diseases.Most of these patients experienced cough,expectoration,fever,shortness of breath and hemoptysis.Chest CT lesions included a consolidation,thin film,pleomorphic changes,portion hilar,mediastinal lymphadenopathy and pleural effusion.12 cases were misdiagnosed at first and the diagnosis of 8 cases was confirmed by etiology.10 cases were cured or improved.Conclusion The risk of PA infection increased in patients with basic diseases.The clinical manifestations and the results of X-ray and chest CT are no-specific and confused in patients with PA.The cure rate may be improved by early diagnosis and proper managements.

关 键 词：肺曲霉菌病 临床表现 诊断 治疗 

分 类 号：R519[医药卫生—内科学]