肾移植术后并发卡氏肺孢子虫肺炎（附4例报告）  

Pneumocystis carinii pneumonia after renal transplantation(report of 4 cases)

作　　者：刘海龙 邓益森 应文伟 李沛哲 何宇辉 丁振山 周晓峰 LIU Hai-long;DENG Yi-sen;YING Wen-wei(Journal of China-Japan Friendship Hospital)

机构地区：[1]中曰友好医院泌尿外科,北京100029 [2]北京大学中日友好临床医学院,北京100029

出　　处：《中日友好医院学报》2019年第6期335-337,388,F0002,共5页Journal of China-Japan Friendship Hospital

摘　　要：目的:探讨肾移植术后并发卡氏肺孢子虫肺炎(PCP)的早期诊断和治疗。方法:综合分析我院2018年3月〜2019年3月间肾移植术后并发P C P者4例。其发病时间均在术后3〜6个月内,初始症状均为发热、伴有呼吸闲难和干咳。用深部诱导痰法检测病原体,口服联黄屮氧苄啶片治疗,疗程大于2周,并辅以对症支持治疗。结果:4例患者痰液分析均检测出卡氏肺孢子虫,经治疗临床症状消失,胸部C T等检查恢复正常。所有患者随访3〜5个月,无卡氏肺孢子虫肺炎复发结论:对于肾移植术后早期(3〜6个月),出现发热、呼吸困难、干咳等临床表现者,应高度怀疑PCP,深部诱导痰检测法是早期诊断PCP的有效手段,尽早治疗是PCP治愈的关键。Objective:To investigate the early diagnosis and treatment of Pneumocystis carinii pneumonia(PCP)after renal transplantation.Methods:From March 2018 to March 2019 in our hospital,there were 4 patients with PCP after renal transplantation,including 3 males and 1 female.The onset time was 3 to 6 months after surgery,the initial symptoms were fever,accompanied by difficulty breathing and dry cough.The pathogens detected by deep induced sputum were treated with conjugated trimethoprim tablets for more than 2 weeks,supplemented by symptomatic supportive treatment.Results:The sputum analysis of these 4 patients showed the presence of Pneumocystis carinii.After treatment,the clinical symptoms disappeared and chest CT examination returned to normal.During 3 to 5 months of follow-up,no recurrence of Pneumocystis carinii pneumonia was found in all the patients.Conclusion:For patients with early clinical manifestations(3 to 6 months),such as fever,dyspnea,dry cough,etc.PCP should be highly suspected.Deep induced sputum can he the effetive choice for early diagnosis of PCP.Early treatment is the key to the success of PCP cure.

关 键 词：卡氏肺孢子虫肺炎 肾移植 i秀导痰 诊断 治疗 

分 类 号：R692.5[医药卫生—泌尿科学]