慢性活动性新型冠状病毒感染的Goods综合征病1例  

Goods syndrome in chronic active SARS-CoV-2 infection:a case report

作　　者：莫华恒 黄宏[1] 罗劲[1] 刘丽华[1] 郭栋伟 孔晋亮[1] 王可[1] Mo Huaheng;Huang Hong;Luo Jin;Liu Lihua;Guo Dongwei;Kong Jinliang;Wang Ke(Department of Pulmonary and Critical Care Medicine,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Pulmonary and Critical Care Medicine,Liuzhou City Hospital of Traditional Chinese Medicine,Liuzhou 545000,China)

机构地区：[1]广西医科大学第一附属医院呼吸与危重医学科,南宁530021 [2]柳州市中医医院呼吸与危重症医学科,柳州545000

出　　处：《中华结核和呼吸杂志》2024年第9期834-838,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：国家自然科学基金(82260023,81760024,82160783,81760743,82104499);广西自然科学基金(2022GXNSFAA035646);广西科技厅重点研发计划项目(桂科AB21196010)。

摘　　要：患者女性,年龄54岁,近1年来反复出现咳嗽、咳痰症状,并多次住院治疗。胸部CT显示双肺有渗出性病变,经过治疗后部分吸收,但出院后不久再次发作。在过去的1年中,该患者共住院6次,在不同时间点通过咽拭子检测新型冠状病毒核酸阳性4次。在外院接受抗感染、抗病毒及对症支持治疗后,上述症状得到缓解且咽拭子核酸转阴,但仍然反复发作。最终根据患者入院时B细胞缺失、免疫球蛋白水平降低和CD4+/CD 8+比值倒置等结果,以及既往胸腺瘤病史诊断为Goods综合征。A 54-year-old female patient presented with recurrent cough and sputum production over the past year and was hospitalized several times.CT examination revealed exudative lesions in both lungs,which were partially absorbed after treatment.However,they recurred shortly after discharge,and the patient had to be readmitted.In the past year,the patient had been hospitalized six times,and her throat swabs were positive for SARS-CoV-2 at four different points in time.After receiving anti-infective and antiviral treatment in other hospitals,the above symptoms were relieved.The patient tested negative for SARS-CoV-2,but symptoms recurred soon after.Eventually,the diagnosis of Goods syndrome was made based on the presence of B-cell loss,decreased immunoglobulin levels,an inverted CD4+/CD8+ratio on admission,and a previous history of thymoma.

关 键 词：慢性活动性 渗出性病变 胸腺瘤 对症支持治疗 胸部CT 出院后 咳痰症状 免疫球蛋白水平 

分 类 号：R593.2[医药卫生—内科学]