【摘要】 目的分析广西地区肺真菌病的病原学、高危因素及临床特征,以期提高肺真菌病的临床诊治水平。方法回顾性收集2004—2013年在广西壮族自治区人民医院住院的89例肺真菌病患者的临床资料,设计肺真菌病调查表,收集患者一般资料、病原学、基础疾病、高危因素、临床特征及预后等资料。结果 89例肺真菌病患者致病菌构成中,以曲霉〔37例(41.6%)〕和隐球菌〔32例(36.0%)〕常见,其他包括假丝酵母菌〔6例(6.7%)〕、诺卡菌〔5例(5.6%)〕、马尔尼菲青霉菌〔5例(5.6%)〕、毛霉〔3例(3.4%)〕和肺孢子菌〔1例(1.1%)〕。56例(62.9%)患者存在基础疾病,以肺部疾病41例(46.1%)为主;11例(12.4%)患者存在高危因素。临床症状主要表现为咳嗽〔62例(69.7%)〕、咳痰〔59例(66.3%)〕、发热〔14例(15.7%)〕、咯血〔13例(14.6%)〕、胸痛〔9例(10.1%)〕、呼吸困难〔9例(10.1%)〕。肺部体征包括湿啰音30例(33.7%)、干啰音19例(21.4%)和哮鸣音6例(6.7%)。结论肺曲霉病和肺隐球菌病是最常见的肺真菌病;多数患者具有基础疾病或高危因素,其中以肺部疾病为主;临床表现为常见呼吸道症状,未见明显特异性。更多还原

【Abstract】 Objective To investigate the pathogen constitute,the high- risk factors and clinical manifestations of pulmonary fungal disease in Guangxi,in order to improve the clinical diagnosis and treatment. Methods We conducted a single- center retrospective study of histologically verified 89 cases of pulmonary fungal disease in the People’ s Hospital of Guangxi Zhuang Autonomous Region from 2004 to 2013. Pulmonary fungal disease questionnaire was designed. The general information,pathogen constitute,underlying diseases,high- risk factors,clinical manifestations,outcome and etc. were collected. Results The top 2 pathogens were pulmonary aspergillosis( 37 cases,41. 6%) and pulmoanry cryptococcosis( 32 cases,36. 0%),followed by pulmonary candidasis( 6 cases, 6. 7%), pulmoanry nocardiosis( 5 cases, 5. 6%), pulmonary penicillium marneffei( 5 cases,5. 6%),pulmonary mucormycosis( 3 cases,3. 4%),and pneumocystis jirovecii pneumonia( 1 case,1. 1%) in the pathogen constitute of all 89 cases of pulmonary fungal disease. Fifty- six cases( 62. 9%) had underlying diseases,which were mainly pulmonary diseases( 41 cases,46. 1%) and 11 cases( 12. 4%) had high- risk factors. The most common clinical symptoms were cough( 62 cases,69. 7%), expectoration( 59 cases,66. 3%), fever( 14 cases,15. 7%),hemoptysis( 13 cases,14. 6%),chest pain and dyspnea( both 9 cases,10. 1%). The medical signs of lungs included crakles( 30 cases,33. 7%), dry rales( 19 cases,21. 4%) and wheeze( 6 cases, 6. 7%). Conclusion Pulmonary aspergillosis and pulmonary cryptococcosis are the most common pulmonary fungal pathogens. Most of the pulmonary fungal disease patients have underlying diseases and high- risk factors,mainly pulmonary diseases. The most common clinical manifestations are respiratory symptoms and without obvious specificity.更多还原