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目的探讨艾滋病合并卡氏肺孢子虫肺炎的临床特点、诊断和治疗。方法对2008年5月～2011年8月间经重庆市公共卫生医疗救治中心诊治的161例AIDS合并PCP患者的临床资料进行分析。结果发热、咳嗽、进行性呼吸困难是最常见的临床症状,CD4+T淋巴细胞数为:2～199/μl,其中110例患者CD4+T淋巴细胞小于50/μl;典型影像表现是肺部磨玻璃影;161例PCP患者经过复方磺胺甲基异噁唑治疗,重症患者联合糖皮质激素治疗,对合并其他机会感染予以相应治疗,其中127例患者于治疗21d后,症状不同程度的改善,15例未愈自动出院,19例死亡。结论 PCP是AIDS常见的机会性感染之一,其发病率高,常合并多种病原菌感染,早期诊断和治疗困难,及时抗PCP及行相应对症支持治疗能缩短病程,改善预后。
Objective To investigate the clinical features, diagnosis and treatment of AIDS with Pneumocystis carinii pneumonia. Methods The clinical data of 161 AIDS patients with PCP diagnosed and treated by Chongqing Public Health Medical Center from May 2008 to August 2011 were analyzed. Results Fever, cough and progressive dyspnea were the most common clinical symptoms. The number of CD4 + T lymphocytes was 2 ~ 199 / μl, of which 110 cases had CD4 + T lymphocytes less than 50 / μl. The typical imaging findings were pulmonary Ground glaucoma; 161 cases of PCP patients after compound sulfamethoxazole treatment, severe patients with glucocorticoid therapy, combined with other opportunistic infections to be treated accordingly, of which 127 patients after 21 days of treatment, the symptoms improved to varying degrees, 15 cases were not discharged automatically, 19 died. Conclusions PCP is one of the common opportunistic infections of AIDS. The incidence of PCP is high. It is often associated with multiple pathogenic bacteria infections. It is difficult to diagnose and treat PCP in a timely manner. Timely anti-PCP and corresponding symptomatic supportive care can shorten the course and improve the prognosis.