天津医药

• 临床论丛 •    下一篇

支气管肺泡灌洗对卡氏肺孢子虫肺炎的诊断价值

陈佳宁1,蒋萍2,郑洪2,余更生3   

  1. 1. 天津市第一中心医院，呼吸科
    2. 天津市第一中心医院
    3. 第一中心医院呼吸科
  • 收稿日期:2012-04-16 修回日期:2012-09-29 出版日期:2013-03-15 发布日期:2013-03-15
  • 通讯作者: 陈佳宁

The Diagnostic Value of Bronchoalveolar Lavage to Pneumocystis Carinii Pneumonia

  • Received:2012-04-16 Revised:2012-09-29 Published:2013-03-15 Online:2013-03-15

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摘要：

【摘要】 <正>肺孢子菌是一种机会病原体,由其引发的肺孢子菌肺炎多见于免疫功能低下或免疫缺陷人群。实体器官移植的受者由于长期服用免疫抑制剂很容易并发卡氏肺孢子虫肺炎(PCP)。由于本病的临床症状、体征、X线胸片及常规实验室检查均缺乏特异性,早期诊断十分困难。痰液标本肺孢子菌的检出率很低,而支气管镜可直接观察感染部位的形态改变,通过收集肺泡灌洗液可显著提高诊断率。本文旨在评估 

关键词: 支气管镜肺泡灌洗, 肺炎, 卡氏肺孢子虫, 器官移植

Abstract: 【Abstract】　Objective To evaluate the diagnostic utility of bronchoalveolar lavage（BAL）in solid organ transplant (SOT) recipients with Pnuemocystis carinii pneumonia(PCP) . Methods 117 bronchoscopys with BAL were performed in 114 SOT hospitalized recipients with suspected pulmonary infections in our hospital. Cytological smear and polymerase chain reaction (PCR) were done to detect P carinii in lavage specimens. Results A definite P carinii etiological diagnosis by BAL was confirmed in 36 patients. P carinii infections alone accounted for 36 episodes, mixed infections by P carinii and CMV accounted for 6 episodes, mixed infections by P carinii and bacterium accounted for 4 episodes. 31 episodes were observed in period 2, 5 episodes in period 3. Conclusion BAL is an extremely useful tool for PCP diagnosis in solid organ transplant (SOT) recipients. The procedure is safe and the results obtained by the technique can guide specific antimicrobial therapy.

Key words: Bronchoalveolar lavage, Pneumonia, Pnuemocystis carinii, Organ transplant