艾滋病合并卡氏肺孢子虫肺炎的诊断和治疗  

The Diagnosis and Treatment of Pneumocystis Carinii Pneumonia in Patient with AIDS

作　　者：张福杰[1] 赵红心[1] 姚均[1] 张晨阳[1] 赵燕[1] 韩宁[1] 曹淑芬[1] 

机构地区：[1]北京地坛医院,100011

出　　处：《中国性病艾滋病防治》2001年第6期332-334,共3页Chinese Journal of Std & Aids Prevention and Control

基　　金：首都医学发展科研基金资助

摘　　要：目的 探讨中国艾滋病病人合并卡氏肺孢子虫肺炎（PCP）的诊断、治疗及PCP的发生与CD4+细胞水平相互关系。方法 对1998～2000年诊断的9例PCP进行全面分析。结果100％有发热,66.7％有咳嗽,77.8％有呼吸困难及咳痰。动脉血氧分压均降低,胸片呈间质样改变,乳酸脱氢酶（LDH）升高,病毒载量极高,CD4+细胞极度减少（平均20/mm3）。复方新诺明（SMZco）治疗反应良好且安全。结论 （1）9例中国艾滋病病人发生 PCP时其细胞免疫功能极度低下。（2）艾滋病合并PCP的特异性诊断是找到病原体,但是典型的临床表现、胸片呈双肺囊状或网状改变、动脉血氧分压降低、LDH升高及SMZco治疗有效可以诊断PCP。objective To explore the diagnosis and treatment of pneumocystic carinii pneumonia in Chinese AIDS patients and the relationship between the PCP of these patients and their CD4 counts. Methods Clinical characteristics of 9 Chinese AIDS patients with PCP during 1998 to 2000 was analyzed. Results Among nine cases, 100% had fever, 66.7% had cough, and 77.8% had breathlessness and expectoration.Chest radiography showed a fine bilateral interstitial, Arterial blood gas pointed out hypoxemia. The level of serum LDH increased. Viral load was high, the CD4 lymphocyte count was very low (average 20/mm3) .The response to treatment of SMZco was good.Conclusion (1) PCP developed in 9 of Chinese AIDS patients when the patient's CD4+ lymphocyte was below 50/mm . (2)Usually establishing of diagnosis of PCP requires the morphologic demonstration of the microorganism, but it is also possibte to diagnosis of PCP by typical clinical findings, cliest X - ray, hypoxemia, increased LDH, and effective treatment with SMZco.

关 键 词：艾滋病 卡氏肺孢子虫肺炎 CD4^+细胞 复方新诺明 

分 类 号：R512.91[医药卫生—内科学] R563.1[医药卫生—临床医学]