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过去二十多年,卡氏肺孢子虫肺炎(PCP)主要见于免疫缺陷患者的呼吸道感染症。近年由于恶性肿瘤、脏器移殖和SLE等胶原病患者大量使用激素和免疫抑制剂以及艾滋病的流行等,PCP患病率逐趋上升。过去4年间本院诊断PCP15例(男性10例,女性5例,平均年龄53.3岁)。生前获得诊断的仅10例,其余为死后诊断。原发疾病中成人T细胞性白血病12例,RA2例,急性淋巴性白血病、特发性间质性肺炎、SLE各1例(有并发)。主要症状是呼吸困难14例,咳嗽14例,高热9例,低热4例。全部病例均有X线异常所见,两侧性12例,单侧3例,多数为间质性、肺泡性浸润,仅1例出现空洞。听诊上和肺野的浸润影相一致,于吸气末可听到罗音,喘鸣1例,无听诊改变的2例。动脉血气分析,全部病例出现A-aDO_2增加。在生前诊断的10例中,通过纤维支气管镜、肺泡清洗
Over the past two decades, Pneumocystis carinii pneumonia (PCP) has been found predominantly in respiratory tract infections in immunocompromised patients. In recent years, due to malignant tumors, organ transplantation and SLE and other collagen disease in patients with massive use of hormones and immunosuppressive agents and the AIDS epidemic, PCP prevalence increased gradually. In the past 4 years, 15 cases of PCP were diagnosed in our hospital (10 males and 5 females with an average age of 53.3 years). Only 10 cases were diagnosed before his death and the rest were diagnosed after death. Primary disease in adult T-cell leukemia in 12 cases, RA2 cases, acute lymphoblastic leukemia, idiopathic interstitial pneumonia, SLE in 1 case (with concurrent). The main symptoms were dyspnea in 14 cases, cough in 14 cases, fever in 9 cases, fever in 4 cases. All cases were abnormal X-ray findings, both sides of the 12 cases, unilateral in 3 cases, the majority of interstitial, alveolar infiltration, only 1 case of holes. Auscultation and lung field infiltration shadow consistent at the end of inhalation can be heard rales, wheezing in 1 case, no change in 2 cases of auscultation. Arterial blood gas analysis, A-aDO_2 increased in all cases. Of the 10 cases diagnosed before birth, bronchoscopy and alveolar cleansing were performed