49例临床确诊肺真菌病患者的回顾性分析  

Retrospective analysis of 49 patients with clinically confirmed pulmonary mycosis

作　　者：李尔然[1] 葛继文[1] 解影影[1] 于娜[1] 尚俊依[1] 于丹[1] 康健[1] 

机构地区：[1]中国医科大学附属第一医院呼吸疾病研究所,辽宁沈阳110001

出　　处：《中华医院感染学杂志》2015年第18期4206-4208,共3页Chinese Journal of Nosocomiology

基　　金：辽宁省教育厅重点实验室基金资助项目(2009S105)

摘　　要：目的探讨医院肺真菌病的种类、临床微生物学及影像学特征等,为肺真菌病的诊治提供科学依据。方法选取2002年1月-2011年12月符合诊断标准的肺真菌病住院患者,对其临床、微生物学及影像学资料进行回顾性分析,并与我国肺真菌病多中心回顾性调查作一比较。结果共收集到确诊的肺真菌病病例49例,其中依次为肺假丝酵母菌病、肺曲霉菌病、肺隐球酵母菌病及肺孢子菌病,分别占59.2%、28.6%、8.2%及4.0%;肺假丝酵母菌病中以肺白色假丝酵母菌病(11例)及肺热带假丝酵母菌病(10例)为主;患者临床表现以发热为主,占100.0%,胸腔积液也较多见占49.0%,合并的基础疾病主要是恶性肿瘤、糖尿病、肝硬化及慢性阻塞性肺疾病,分别占28.6%、18.4%、16.3%及10.2%。结论医院肺真菌病主要以肺假丝酵母菌病、肺曲霉菌病为主,入选肺真菌病病例多伴有基础疾病及肺真菌病的危险因素,多为院内获得性发病,其中假丝酵母菌属中以白色假丝酵母菌及热带假丝酵母菌为主。OBJECTIVE To explore the types,clinical microbiology,and imaging characteristics of the pulmonary mycosis so as to provide scientific basis for diagnosis and treatment of the pulmonary mycosis.METHODS The patients with pulmonary mycosis who were eligible for the diagnostic criteria and hospitalized from Jan 2002 to Dec2011were enrolled in the study.The clinical,microbiological,and imaging data were retrospectively analyzed and compared with the multicenter retrospective survey of pulmonary mycosis in China.RESULTS A total of 49 patients with confirmed pulmonary mycosis were included,of whom 59.2% had the pulmonary candidiasis,28.6%had the pulmonary aspergillosis,8.2% had the pulmonary cryptococcosis,and 4.0% had the pneumocystis.Among the patients with pulmonary candidiasis,the pulmonary Candida albican disease（11cases）and pulmonary Candida tropicalis disease（10cases）were dominant.The clinical manifestations of the patients were characterized by fever（100.0%）,and pleural effusion（49.0%）was also common;the patients complicated with malignant tumor accounted for 28.6%,the patients complicated with diabetic mellitus 18.4%,the patients complicated with liver cirrhosis 16.3%,the patients with chronic obstructive pulmonary disease 10.2%.CONCLUSION The pulmonary candidiasis and pulmonary aspergillosis are the predominant pulmonary mycosis.The enrolled pulmonary mycosis patients are complicated with underlying diseases and the risk factors for the pulmonary mycosis,most of which are hospital-acquired diseases.The C.albicans and C.tropicalis are dominant among the Candida spp.

关 键 词：肺真菌病 假丝酵母菌病 曲霉菌病 

分 类 号：R563.1[医药卫生—呼吸系统]