肾移植术后并发卡氏肺孢子虫肺炎(附八例报告)  

Study of pneumocystis carinii pneumonia(PCP) following kidney transplantation(report of 8 cases)

作　　者：明爱民[1] 林民专[1] 赵明[1] 岳良升[1] 郭颖[1] 徐永康[2] 

机构地区：[1]第一军医大学珠江医院肾移植科,广州510280 [2]第一军医大学珠江医院呼吸科,广州510280

出　　处：《中华泌尿外科杂志》2003年第7期439-441,共3页Chinese Journal of Urology

摘　　要：目的　探讨肾移植术后并发卡氏肺孢子虫肺炎 (PCP)的早期临床诊断和治疗。　方法　肾移植术后PCP患者 8例 ,均为男性 ,平均年龄 2 8岁。发病于术后 90～ 14 0d ,均行经皮肺穿刺活检确诊。应用复方新诺明 (SMZ) ,辅以对症、支持治疗 ;免疫抑制剂减量。　结果　 6例早期确诊者于治疗第 5～ 7天症状缓解 ;2例合并其他感染延误诊断者病情较重 ,分别于第 2 5、4 6天症状缓解。 8例均康复出院。　结论　对PCP采用经皮肺穿刺活检能早期确诊 ,方法可靠 ,病原体检出率高。早期应用SMZ治疗成功率高 ,并应注意调整免疫抑制剂的种类和剂量。Objective To investigate the clinical diagnosis and treatment of pneumocystis carinii pneumonia(PCP) after kidney transplantation. Methods Eight patients who developed PCP between 90 days and 140 days following renal transplantation were enrolled in this study.All of them were male with a mean age of 28 years.The clinical manifestations,accessory examinations and treatment were retrospectively analyzed. Results All the 8 patients fully recovered.With early diagnosis and administration of compound sulfamethoxazole(SMZ),clinical symptoms of 6 patients were rapidly controlled within 5 to 7 days.Because of delayed diagnosis and treatment,the conditions of the other 2 cases were more severe and were controlled within 25 days and 46 days separately. Conclusions Application of percutaneous pneumocentesis biopsy can be useful for correct diagnosis in early stage of PCP and has high positive rate of the pathogen. Most PCP patients can be cured with early use of SMZ.Types and doses of immunosuppressor should be adjusted properly.

关 键 词：肾移植 术后 卡氏肺孢子虫肺炎 并发症 

分 类 号：R563.1[医药卫生—呼吸系统]