CT肺动脉造影在血液恶性肿瘤患者肺侵袭性霉菌感染诊断中的应用  

Application of CT pulmonary angiography in the diagnosis of invasive pulmonary mold infection in patients with hematological malignancies

作　　者：王淼[1] 杜瑜[2] 王勇[3] 王金岸[3] 胡嘉升[4] WANG Miao;DU Yu;WANG Yong;WANG Jin'an;HU Jiasheng(Department of Respiratory Medicine,Zhongshan Hospital Xiamen University,Fujian,Xiamen 361004,China;Department of Pharmacy,Zhongshan Hospital Xiamen University,Fujian,Xiamen 361004,China;Department of Medical Imaging,Zhongshan Hospital Xiamen University,Fujian,Xiamen 361004,China;Department of Hematology,Zhongshan Hospital Xiamen University,Fujian,Xiamen 361004,China)

机构地区：[1]厦门大学附属中山医院呼吸内科,福建厦门361004 [2]厦门大学附属中山医院药学部,福建厦门361004 [3]厦门大学附属中山医院影像科,福建厦门361004 [4]厦门大学附属中山医院血液科,福建厦门361004

出　　处：《中国医药科学》2021年第3期191-194,共4页China Medicine And Pharmacy

摘　　要：目的评价CT肺动脉造影(CTPA)在血液恶性肿瘤患者肺部侵袭性霉菌感染(IMD)诊断中的应用价值。方法依据《侵袭性肺部真菌感染的诊断标准与治疗原则》,于2018年3月至2019年4月共纳入40例厦门大学附属中山医院血液科的血液系统恶性肿瘤患者,并进一步将其分为确诊、临床诊断和拟诊。对所有患者行CTPA检查,观察影像与临床/微生物之间的关系以及能否利用CTPA协助发现拟诊分类中的IMD患者。结果所有确诊的6例患者均出现肺血管栓塞改变的阳性结果;9例临床诊断患者中,8例CTPA阳性,1例CTPA阴性;25例拟诊患者中,12例CTPA阳性,13例CTPA阴性。结论CTPA可直接发现可疑肺IMD患者肺血管闭塞,其在血液恶性肿瘤患者肺IMD的早期诊断价值值得进一步探讨。Objective To evaluate the value of CT pulmonary angiography(CTPA)in the diagnosis of invasive pulmonary mold infection(IMD)in patients with hematological malignancies.Methods 40 patients with hematological malignancies the department of hematology of Zhongshan Hospital Xiamen University from March 2018 to April 2019 were enrolled according to the Diagnostic Criteria and Treatment Principles of Invasive Pulmonary Mold Infection,and further divided into the confirmed diagnosis,the clinical diagnosis and the prospective diagnosis.All patients were examined by CTPA and the relationship between imaging and clinic/microorganism,and whether CTPA can help to find IMD patients in the classification of prospective diagnoses were observed.Results All the 6 patients with confirmed diagnoses showed positive results of pulmonary vascular embolism changes.Among the 9 patients with clinical diagnoses,8 cases were CTPA positive and 1 case was CTPA negative.Among the 25 patients with prospective diagnoses,12 cases were CTPA positive,while 13 cases were CTPA negative.Conclusion CTPA can directly detect pulmonary vascular occlusion in patients with suspected pulmonary IMD,and its value in early diagnosis of pulmonary IMD in patients with hematological malignancies is worthy of further exploring.

关 键 词：免疫抑制 肺侵袭性霉菌感染 CT肺动脉造影 血液恶性肿瘤 

分 类 号：R730.6[医药卫生—肿瘤]