非HIV感染低淋巴细胞血症肺隐球菌病患者的临床特征分析  

Analysis of clinical characteristics of pulmonary cryptococcosis in the non-HIV-infected patients with low peripheral blood lymphocyte count

作　　者：宗秋 贾林杰 马佳琪 余慕清 王宜 许淑云[1] 赵建平[1] 周敏[1] Zong Qiu;Jia Linjie;Ma Jiaqi;Yu Muqing;Wang Yi;Xu Shuyun;Zhao Jianping;Zhou Min(Department of Respiratory Diseases and Critical Care Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院呼吸与危重症医学科,武汉430030 [2]连云港市第一人民医院呼吸与危重症医学科

出　　处：《临床内科杂志》2024年第1期25-28,共4页Journal of Clinical Internal Medicine

基　　金：国家自然科学基金青年项目(81700032)。

摘　　要：目的 分析非HIV感染低淋巴细胞血症肺隐球菌病(PC)患者的临床特征。方法根据外周血淋巴细胞计数正常范围低限值将104例PC患者分为低淋巴细胞组(32例)与对照组(72例),比较两组患者的一般临床资料、白蛋白水平、临床特征、影像学特征、治疗方式及预后情况。结果 临床特征方面,低淋巴细胞组年龄、头痛、肺外播散、中枢神经系统(CNS)受累比例均高于对照组,无症状比例低于对照组;影像学特征方面,低淋巴细胞组病灶类型为结节肿块型比例低于对照组,伴随征象为空洞及胸腔积液比例均高于对照组;治疗方式及预后方面,低淋巴细胞组手术+抗真菌及单抗真菌治疗、完全缓解及治疗有效比例均低于对照组,稳定及死亡比例均高于对照组(P<0.05)。结论 低淋巴细胞的PC患者年龄大、临床症状多,容易发生肺外播散,影像学表现为结节肿块型的比例较低,出现空洞及胸腔积液的比例较高,预后较差。Objective To analysis the clinical characteristics of pulmonary cryptococcosis(PC) in the non-HIV-infected patients with low peripheral blood lymphocyte count.Methods According to the low limit of normal lymphocyte count in peripheral blood, 104 PC patients were divided into low lymphocyte group(32 cases) and control group(72 cases).General clinical data, albumin levels, clinical features, imaging features, treatment methods and prognosis of the two groups were compared.Results In terms of clinical features, age, the proportion with headache, extrapulmonary transmission and central nervous system(CNS) involvement in low lymphocyte group were higher than that in control group, and the proportion of asymptomatic was lower than that in control group;In terms of imaging features, the proportion with nodular mass lesion type in low lymphocyte group was lower than that in control group, and the proportion with accompanying signs of cavity and pleural effusion were higher than those in control group;In terms of treatment and prognosis, the proportion with surgery+antifungal and monoclonal antifungal treatment, complete remission and effective treatment in low lymphocyte group were lower than those in control group, and the proportion of stable and dead were higher than those in control group(P<0.05).Conclusion PC patients with low lymphocyte count are relatively older and have more clinical symptoms.They are characterized by decreased rate of nodule or mass lesson and increased probability of cavities and pleural effusion as the imaging performance.Moreover, extrapulmonary dissemination is more likely to occur in patients with low lymphocyte count who have a poor prognosis.

关 键 词：肺隐球菌病 HIV感染 临床特征 淋巴细胞 播散 

分 类 号：R563.9[医药卫生—呼吸系统]