[1]张实,刘刚,王美菊,等.拟诊卡氏孢子虫和（或）巨细胞病毒性肺炎患者病原微生物学筛查及治疗策略[J].第三军医大学学报,2015,37(19 ):1976-1980.
　Zhang Shi,Liu Gang,Wang Meiju,et al.Microbial screening and therapeutic strategies for tentative diagnosis of Pneumocystsis carinii pneumonia and/or cytomegalovirus pneumonia[J].J Third Mil Med Univ,2015,37(19 ):1976-1980.
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拟诊卡氏孢子虫和（或）巨细胞病毒性肺炎患者病原微生物学筛查及治疗策略(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
37卷
期数:
2015年第19期
页码:
1976-1980
栏目:
论著
出版日期:
2015-10-15

文章信息/Info

Title:
Microbial screening and therapeutic strategies for tentative diagnosis of Pneumocystsis carinii pneumonia and/or cytomegalovirus pneumonia
作者:
张实; 刘刚; 王美菊; 李琦
第三军医大学新桥医院重症医学科
Author(s):
Zhang Shi;  Liu Gang;  Wang Meiju;  Li Qi

Department of Critical Medicine, Xinqiao Hospital, Third Military Medical University, Chongqing, 40037, China

关键词:
肺孢子虫;  巨细胞病毒;  病原微生物筛查;  治疗策略
Keywords:
Pneumocystsis carinii pneumonia;  cytomegalovirus;  microbial screening;  therapeutic strategy
分类号:
R446.5; R563.1
文献标志码:
A
摘要:

目的      通过病原微生物学筛查及对照实验两个方面，为拟诊卡氏肺孢子虫（pneumocystsis carinii pneumonia，PCP）和（或）巨细胞病毒（cytomegalovirus，CMV）性肺炎患者寻找最佳诊疗策略。      方法      192例拟诊患者肺组织标本及BALF标本微生物学镜检，ELISA检测患者血清CMV抗体；荧光定量PCR检测患者血清巨细胞病毒DNA含量。将仅CMV阳性和仅PCP阳性的患者分为两组，一组为覆盖PCP和CMV的联合治疗组，一组为仅覆盖PCP或CMV的单独治疗组，比较两组的住院时间及“14 d内病情缓解率”。      结果      微生物学检验阳性患者共136人；其中仅CMV阳性17人；仅PCP阳性21人；PCP与CMV均阳性98人。联合治疗组住院时间显著短于单独治疗组（W=162.5,P=0.006），联合治疗组“14 d内病情缓解率”显著高于单独治疗组（χ2=6.454,P=0.011）。      结论      PCP与CMV混合感染多见，单独PCP或CMV一项感染少见；覆盖PCP和CMV的联合治疗效果更好。

Abstract:

Objective      To investigate optional therapeutic strategies for suspected Pneumocystsis carinii pneumonia (PCP) and/or cytomegalovirus (CMV) pneumonia by microbial screening and control experiment.       Methods      Microbial screening included 3 parts, which were microbiological microscopy for patients’ lung specimens and bronchoalveolar lavage fluid (BALF), detection of serum CMV antibody by ELISA and detection of serum CMV DNA content by fluorescence quantitative PCR. The patients who were positive to only CMV or PCP were respectively divided into 2 groups, that is, the combined treatment group and the single treatment group (CMV or PCP as corresponded). The length of hospital stay and the remission rate after 14 days'treatment were compared between the 2 groups.       Results      There were totally 136 positive patients, including 17 only positive to CMV, 21 only to PCP and 98 with double positive of PCP and CMV. The length of hospital stay were shorter in the combined treatment group than the single treatment groups (W=162.5, P=0.006). The remission rate were also obviously higher in the former than the latter groups (χ2=6.454, P=0.011).       Conclusion      It is quite common for mixed infection of PCP and CMV pneumonia, but rare for single infection. So, the combined treatments are more effective than the single one.

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更新日期/Last Update: 2015-09-28