1例非HIV肺孢子菌肺炎是否需要糖皮质激素辅助治疗的病例分析  

The Need for Glucocorticoid Adjuvant Therapy in A Case of Non-HIV Pneumocystis Carinii Pneumonia

作　　者：刘菊媚 陈杰[2] 刘惠霞 熊锋 廖晗 陈文露 赖剑峰 魏洁 LIU Jumei;CHEN Jie;LIU Huixia;XIONG Feng;LIAO Han;CHEN Wenlu;LAI Jianfeng;WEI Jie(Huidong County People's Hospital,Huizhou,Guangdong 516300,China;The First Affiliated Hospital,Sun Yat-sen University,Guangzhou,Guangdong 510080,China)

机构地区：[1]惠东县人民医院,广东惠州516300 [2]中山大学附属第一医院,广东广州510080

出　　处：《今日药学》2025年第2期123-126,共4页Pharmacy Today

摘　　要：目的探讨非人类免疫缺陷病毒(Human Immunodeficiency Virus,HIV)的肺孢子菌肺炎(pneumocystis pneumonia,PJP)是否需要糖皮质激素辅助治疗。方法通过系统性地回顾文献,对1例非霍奇金淋巴瘤合并PJP的患者是否需要糖皮质激素辅助治疗进行分析讨论。结果通过分析讨论,对于非HIV PJP患者,如果呼吸室内空气时动脉血气检测显示血氧分压(PaO_(2))<70 mm Hg或肺泡-动脉(肺泡动脉,A-a)氧梯度≥35 mm Hg,或者脉搏血氧测定显示低氧血症(如呼吸室内空气时血氧饱和度<92%),建议给予糖皮质激素治疗,而结合患者的病情,使用糖皮质激素辅助治疗是合理的。结论对于非HIV的中至重度PJP患者,应根据氧合情况进行判断是否需要辅助使用糖皮质激素治疗。OBJECTIVE To investigate whether glucocorticoid adjuvant therapy is needed for non-HIV pneumocystis pneumonia(PJP).METHODS Through a systematic review of the literature,the need for glucocorticoid adjuvant therapy in a patient with non-Hodgkin's lymphoma combined with PJP was analyzed and discussed.RESULTS By analysis and discussion,glucocorticoid therapy was recommended for patients with non-HIV PJP who had an arterial blood gas test showing a partial pressure of oxygen(PaO_(2))<70 mm Hg or an alveolar-arterial(A-a)oxygen gradient of≥35 mm Hg when breathing room air.Additionally,pulse oximetry showing hypoxemia(e.g.,oxygen saturation<92%when breathing room air)in combination with the patient's condition supports the use of adjunctive glucocorticoid therapy.CONCLUSION In non-HIV patients with moderate to severe PJP,the need for adjunctive glucocorticosteroid therapy should be determined by the oxygenation status.

关 键 词：非HIV肺孢子菌肺炎 低氧血症 糖皮质激素 

分 类 号：R969[医药卫生—药理学]