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目的提高对卡氏肺囊虫肺炎（ＰＣＰ）的认识。方法回顾性分析６例ＰＣＰ患者资料。结果６例ＰＣＰ基础疾病为白血病、淋巴瘤、肾移植和溶血性贫血。临床表现为呼吸困难、咳嗽和发热。Ｘ线表现为双肺弥漫性肺泡性或间质性改变或无改变。治疗首选复方新诺明（ＳＭＺｃｏ）和氨苯砜。３例并发呼吸衰竭，表现与成人呼吸窘迫综合征（ＡＲＤＳ）相似的低氧血症、肺内分流和顺应性下降。持续气道正压通气／呼气末正压通气（ＣＰＡＰ／ＰＥＥＰ）为常用模式。顽固性低氧血症可试用高水平（＞１４７ｋＰａ）ＰＥＥＰ治疗。结论卡氏肺囊虫肺炎并发急性呼吸衰竭者预后差，争取早期诊断与治疗是提高生存率的关键。
Objective To improve the understanding of Pneumocystis carinii pneumonia (PCP). Methods Retrospective analysis of 6 cases of PCP patients. Results Six cases of PCP underlying diseases were leukemia, lymphoma, kidney transplantation and hemolytic anemia. Clinical manifestations of dyspnea, cough and fever. X ray showed diffuse alveolar pulmonary interstitial or interstitial changes or no change. The treatment of choice for the combination of cotrimoxazole (SMZco) and dapsone. Three patients had concurrent respiratory failure, exhibiting hypoxemia similar to that of adult respiratory distress syndrome (ARDS), with decreased shunt and compliance. Continuous positive airway pressure / positive end expiratory pressure (CPAP / PEEP) is the common mode. Refractory hypoxemia can try high level (> 1 47kPa) PEEP treatment. Conclusions Pneumocystis carinii pneumonia complicated by acute respiratory failure have poor prognosis, and seeking for early diagnosis and treatment is the key to improve survival rate.