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与艾滋病患者相比,HIV抗体阴性的免疫抑制患者PCP起病更急骤,及时诊断更困难,呼吸衰竭发生率更高,预后更差。支气管肺泡灌洗、口咽冲洗能提高检出率,PCR技术有助于快速诊断。抗菌药物目前仍首选SMZ/TMP,糖皮质激素适用于重度PCP的辅助治疗。对于免疫功能严重低下的患者,如CD4T淋巴细胞低于200/mm3,推荐SMZ/TMP预防治疗。
Patients with HIV antibody-negative immunosuppression are more likely to have a more acute onset of PCP, more difficult to diagnose in time, have a higher incidence of respiratory failure, and have a worse prognosis than HIV-infected patients. Bronchoalveolar lavage and oropharyngeal flushing can improve the detection rate, and PCR technology can facilitate rapid diagnosis. Antibiotics is still the preferred SMZ / TMP, glucocorticoid for adjuvant treatment of severe PCP. For patients with severe immunocompromise, such as CD4 T lymphocytes below 200 / mm3, SMZ / TMP prophylaxis is recommended.