慢性阻塞性肺疾病合并侵袭性肺曲霉病35例文献分析  

Literature review of 35 cases of chronic obstructive pulmonary disease complicated with invasive pulmonary aspergillosis

作　　者：刘菁[1] 刘学东[1] 

机构地区：[1]山东省青岛市市立医院呼吸科(西院),山东青岛266021

出　　处：《中国感染与化疗杂志》2013年第4期255-257,共3页Chinese Journal of Infection and Chemotherapy

摘　　要：目的总结10年来国内报道的慢性阻塞性肺疾病(COPD)合并侵袭性肺曲霉病(IPA)的危险因素、临床特点、影像学特点、诊断方法,为临床医师早期、快速、准确地诊断该病提供依据。方法回顾性分析2002—2012年国内有关COPD合并IPA的文献资料,统计分析并总结了35例COPD合并IPA患者的临床资料。结果 35例患者中应用广谱抗生素33例,长期应用糖皮质激素34例。常见症状是呼吸困难、胸闷憋气、胸痛、发热和肺部啰音。结论使用广谱抗生素、长期激素治疗、有创操作是COPD合并IPA的危险因素,患者临床和胸部CT表现多样,缺乏特异性;减少危险因素,做到早期诊断和早期治疗是改善预后的有效方法。Objective To review the reported cases of invasive pulmonary aspergillosis（IPA）in the patients with chronic obstructive pulmonary disease（COPD）in recent 10 years in China in terms of risk factors,clinical and imaging characteristics,in an attempt to provide important clues for prompt and accurate diagnosis.Methods The literature reports of COPD complicated with IPA from2002 to 2012in China were analyzed retrospectively.A total of 35 cases were identfied and reviewed in terms of the relevant clinical data.Results Broad spectrum antibiotic treatment was found in 33 of the 35 cases.Long-term use of glucocorticoids was documented in 34 cases.The most common clinical symptoms included dyspnea,chest tightness,breathlessness,chest pain,fever and pulmonary rales.Conclusions Broad spectrum antibiotic treatment,long-term use of glucocorticoids and invasive procedures are the risk factors of IPA in COPD patients.The clinical manifestations are variable and nonspecific.Early diagnosis and empirical antifungal treatment are effective for improving the outcome.

关 键 词：侵袭性肺曲霉病 慢性阻塞性肺疾病 文献分析 

分 类 号：R563.9[医药卫生—呼吸系统]