慢性阻塞性肺疾病合并肺曲菌病一例及文献复习

目的:提高对慢性阻塞性肺疾病合并侵袭性肺曲菌病(COPD合并IPA)临床特点、诊断及治疗的认识.方法:回顾性分析2011年4月收治的一例COPD合并IPA患者的临床资料及诊治经过,并复习相关文献.结果:男患,“咳嗽、咳痰30余年,气短3年,加重1月余”入院,肺部CT示双肺多发结节影、空洞影,经抗炎、抗念珠菌治疗无效,CT下肺结节病灶活检病理示肺曲菌.抗曲菌治疗后症状好转、肺部影像明显吸收.结论:COPD合并IPA正逐渐引起重视,临床特征无明显特异性,肺部影像以结节影、空洞影多见,早期常规治疗无效时应积极抗曲菌治疗,可明显改善症状,降低死亡率,病理活检是确诊的依据.

Chronic Obstructive Pulmonary Disease with Pulmonary Aspergillosisand a Literature Review

Objective: To improve the understanding of chronic obstructive pulmonary disease with invasive pulmonary aspergillosis(COPD with IPA) in clinical characteristics,diagnosis and treatment.Methods: Analysize one of the patients with COPD with IPA in April 2011 in the clinical data of diagnosis and treatment and the related literatures were reviewed.Results: "A cough,sputum more than 30 years,shortness of breath for 3 years,worsen for one month’s time",and the hospital in lung CT double lung nodules are visible shadows,empty,anti-inflammatory,the shadow of candida,CT treated under nodule of lung biopsy pathology is pulmonary aspergillosis Resistance to pulmonary aspergillosis after treatment,symptoms improved lung imaging obvious absorption.Conclusion: Pay more attention in COPD with IPA,clinical features have no obvious specificity,lung imaging shadow,empty to nodules shadow,when early routine treatment is invalid,should be active resistance to pulmonary aspergillosis,can greatly improve symptoms,reduce mortality,pathological biopsy is diagnosed basis.