肾移植患者肺部浸润的病原学分析及支气管镜应用价值  

Etiology of pulmonary infiltration of renal transplant recipients and value of bronchoscopy

作　　者：陈佳宁[1] 蒋萍[1] 郑洪[1] 

机构地区：[1]天津市第一中心医院呼吸科,天津300192

出　　处：《中华医院感染学杂志》2013年第1期50-52,共3页Chinese Journal of Nosocomiology

摘　　要：目的研究肾移植患者肺部浸润的病原学特点及支气管镜检查诊断性应用价值,为临床诊断与治疗提供依据。方法 2006年11月-2011年9月88例肾移植患者因肺部浸润共进行90次支气管镜检查,包括支气管肺泡盥洗和防污染毛刷。结果 55例通过支气管镜获得了明确的病原学诊断,其中单独卡氏肺孢子虫感染23例占41.82%,单独巨细胞病毒感染11例占20.00%,单独细菌感染3例占5.45%,单独结核分枝杆菌感染2例占3.64%;混合感染共16例占29.09%;大多数机会性感染发生在第2阶段,少部分发生在第3阶段。结论支气管镜检查对评估肾移植患者的肺部浸润是一种极为有效的方法,特别对第2、3阶段的机会性感染的诊断具有极高的价值。OBJECTIVE To analyze the microbiologic features of pulmonary infiltration in renal transplant patients and study the value of hronchoscope in examination and diagnosis so as to provide basis for clinical diagnosis and treatment. METHODS From Dec 2006 to Sep 2011, 88 renal transplant patients with 90 episodes of pulmonary infiltrates were studied using bronchoscope with protected specimen brush （PSB） or bronchoalveolar lavage （BAL）. RESULTS A definite infectious etiology was confirmed in 55 episodes （61.11%）. Pneumocystis carinii infections alone accounted for 23 episodes （41.82%）, cytomegalovirus （CMV） infections alone accounted for 11 episodes（20. 00%）, bacterial infections alone accounted for 3 episodes （5. 45%）, Mycobacterium tuberculosis alone accounted for 2 episodes （3.64%）, the mixed infections were found in 16 episodes （29. 09%）, most opportunistic pneumonia episodes were observed in phase 2 and, small part in phase 3. CONCLUSION Bronchoscopy is an extremely useful tool evaluating renal transplant recipients with pulmonary infiltration and provides great value especially for diagnosis of opportunistic infections in period 2 and period 3.

关 键 词：支气管镜 检查 肾移植 肺部浸润 

分 类 号：R181.32[医药卫生—流行病学]