国际医药卫生导报2012，Vol.18Issue(11)：1548-1550,3.DOI:10.3760/cma.j.issn.1007-1245.2012.11.002
肝衰竭患者合并侵袭性肺曲霉菌病临床分析
A clinical analysis on invasive pulmonary aspergillosis in patients with hepatic failure
摘要
Abstract
Objective To explore the risk factors,clinical characteristics,and proguosis ofinvasive pulmonary aspergillosis ( IPA ) in patients with hepatic failure.Methods The clinical data of 15 patients with hepatic failure complicated with IPA were analyzed retrospectively.Results All the patients had an underlying disorder that was chronic hepatitis B,but had no granulocytopenia or agranulocytosis.The MELD score was ( 37.13 ± 11.03 )46.7％ ( 7/15 ) of the patients had history of hormone uses ; 60％ ( 9/15 ) had history of broad-spectrum antibiotic uses ( single or mulitple ) 60％ ( 9/15 )of patients received previous blood purification.33.3％ ( 5/15 )had a reduction in CD4+ T cells or ratio imbalance.Clinical manifestations lacked of obvious specificity.Roentgenographic examination of the lungs showed changes in all the patients; GM test was positive in 73.3％ ( 11/15 )of the patients.20％ ( 3/15 )of the patients improved after treatment; 80％ ( 12/15 ) did not repond to therapies; and 40％ ( 6/15 ) were dead within 7 days after diagnosis.Conclusions Patients with hepatic failure have multiple risk factors of invasive pulmonary aspergillosis.IPA is one of the reasons for deterioration in patients with hepatic failure.Early CT examination combined with GM tests can increase the early diagnostic rate.Early effective antifungal therapy can improve the prognosis of the disease.关键词
肝衰竭/侵袭性肺曲霉菌病/危险因素/预后Key words
Hepatic failure/Invasive pulmonary aspergillosis/Risk factors/Prognosis引用本文复制引用
邓西龙,陈志敏,黄煌,潘越峻,李粤平..肝衰竭患者合并侵袭性肺曲霉菌病临床分析[J].国际医药卫生导报,2012,18(11):1548-1550,3.基金项目
广东省科技厅课题(2011B031800392) （2011B031800392）
