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[目的]探讨矽肺并发曲霉菌病早期诊断的有效方法。[方法]回顾性分析2012年1月—2013年1月在杭州市红十字会医院职业病科住院的2例矽肺并发曲霉菌患者的诊疗过程,包括高危因素的评价、实验室检查:血总免疫球蛋白(IgE)、血1,3β-D葡聚糖检测(G实验)及半乳甘露聚糖抗原检测(GM实验),痰培养等,以及胸部CT的特征性表现等。[结果]长期营养不良、广谱抗生素及糖皮质激素使用等,是并发肺部真菌病的高危因素,血IgE升高、G实验及GM实验阳性,胸部CT的“新月征”等均是其诊断的重要辅助方法。[结论]矽肺合并多种高危因素者,辅助相应的实验室检查,结合胸部CT特征性表现,综合分析病情,有助于早期发现矽肺并发肺部曲霉菌感染。
[Objective] To discuss the effective method of early diagnosis of silicosis complicated with Aspergillus disease. [Methods] The clinical data of 2 patients with silicosis complicated with Aspergillus who were hospitalized in Department of Occupational Diseases, Hangzhou Red Cross Hospital from January 2012 to January 2013 were retrospectively analyzed. The evaluation included high risk factors, laboratory tests, IgE, blood β-1,3-D-glucan test (G test) and galactomannan antigen test (GM test), sputum culture, etc., as well as the chest CT characteristic manifestations. [Result] Long-term malnutrition, broad-spectrum antibiotics and glucocorticoid use were the risk factors of pulmonary mycosis complicated with elevated serum IgE, positive G test and GM test, and chest CT CT scan. Are important ancillary methods for their diagnosis. [Conclusion] Silicosis combined with a variety of risk factors, assisted by the corresponding laboratory tests, combined with chest CT characteristic manifestations, a comprehensive analysis of the disease, help to early detection of silicosis complicated by pulmonary aspergillus infection.