31例非获得性免疫缺陷综合征肺隐球菌病临床分析

目的通过研究非获得性免疫缺陷综合征肺隐球菌病的临床特点,提高医务人员对肺隐球菌病的认识,做到早期诊断和治疗。方法回顾性分析2001年1月至2011年12月在南京医科大学附属杭州市第一人民医院确诊的31例非获得性免疫缺陷综合征肺隐球菌病患者的性别、年龄分布、职业情况、伴随的基础疾病、临床症状、实验室检查、影像学特征、治疗方案及预后等各方面特点。结果肺隐球菌病发病年龄有年轻化趋势,临床特点及影像学表现缺乏特异性,极易误诊及漏诊。治疗方法及药物少,病程长。结论肺隐球菌病虽然临床表现缺乏特异性,但从病例分析结果来看诊治该病仍有一定规律可循,亟需提高对本病的认识,遇到疑似病例应行血乳胶凝集试验及肺活检或手术病理予以明确,药物治疗需要足够疗程。

A clinical analysis on 31 cases of non-AIDS pulmonary cryptococcosis

Objective To improve early diagnosis and treatment effect of pulmonary cryptoccosis by analyzing the clinical characteristics of non-AIDS pulmonary cryptococcosis. Methods Retrospective analysis was performed on the clinical data of patients with physician-diagnosed non-AIDS pulmonary cryptococcosis in our hospital from Jan 2001 to Dec 2011. We analyzed 31 patients with regard to their demographical data, clinical baseline, clinical symptoms and signs, laboratory data, imaging findings and prognosis. Results The results showed that in recently years the onset age of non-AIDS pulmonary eryptocoeeosis was younger than ever before. Its clinical manifestation and imaging findings were lack of specificity, which might result in missed diagnosis or misdiagnose. Moreover, effective treatments for the disease were lacking and the course of treatment was long. Conclusion Although the disease is lack of specific clinical manifestations and imaging findings, we still can find some useful clues. Once a case is suspected pulmonary crypt occosis, serum latex agglutination test should be performed and lung tissue biopsy or histopathology should be made for diagnosis. A long-term therapy with drugs is essential.