Pothoff G, Wassermann K, Julius B, Hilger H H
Klinik III für Innere Medizin, Universität zu Köln.
Pneumologie. 1992 Jun;46(6):221-5.
Significant impairment of lung volumes and gas exchange in HIV-infected patients with acute Pneumocystis carinii pneumonia (PCP) has been reported, whereas little is known about lung function compromise following successful therapy. In 9 patients with acute PCP and 9 patients 1-5 month after PCP lung function testing including spirometry, diffusing capacity for carbon monoxide and exercise blood gas analysis were performed serially at monthly intervals. The results were summarized in a total score. The mean period of follow-up for each patient was 7.2 +/- 2 months. A decrease in lung volumes (FEV1 67 +/- 14.2% pred.norm., VC 72.7 +/- 11.9% pred.norm.) and gas exchange (CO-transfer factor 53.2 +/- 18.5% pred.norm., CO-transfer coefficient 67.8 +/- 14.2 pred. norm.) was observed in all 9 patients with acute PCP. Post-PCP lung volumes normalized within 1 month, whereas disorders in gas exchange persisted for 1-3 months. The total score normalized in 16/18 patients. One of the remaining patients with persisting functional impairment had chronic obstructive airway disease, whereas in the other dysfunction was even observed prior to PCP and no diagnosis could be obtained. 2-6 months following acute disease a second period of decreased lung function occurred in 6 pts. In 3 of the 6 there were no clinical signs of infection (rebronchoscopy refused), in 1 patient infection with cytomegalovirus was suspected. In the other 2 patients a relapse of PCP was diagnosed by bronchoscopy.
Acute PCP compromises lung mechanics and gas exchange. During recovery deficits in gas exchange persist longer than diminished lung volumes.(ABSTRACT TRUNCATED AT 250 WORDS)
据报道，患有急性卡氏肺孢子虫肺炎（PCP）的HIV感染患者的肺容量和气体交换存在显著损害，而对于成功治疗后肺功能受损情况却知之甚少。对9例急性PCP患者以及9例PCP后1至5个月的患者，每月定期进行包括肺活量测定、一氧化碳弥散能力和运动血气分析在内的肺功能测试。结果汇总为总分。每位患者的平均随访期为7.2±2个月。所有9例急性PCP患者均出现肺容量（第一秒用力呼气量67±14.2%预计正常值，肺活量72.7±11.9%预计正常值）和气体交换（一氧化碳转移因子53.2±18.5%预计正常值，一氧化碳转移系数67.8±14.2预计正常值）下降。PCP后肺容量在1个月内恢复正常，而气体交换障碍持续1至3个月。16/18例患者的总分恢复正常。其余两名仍有持续功能损害的患者中，一名患有慢性阻塞性气道疾病，而另一名在PCP之前就已出现功能障碍且未明确诊断。急性疾病后2至6个月，6例患者出现第二个肺功能下降期。其中3例无感染临床症状（拒绝再次支气管镜检查），1例怀疑感染巨细胞病毒。另外2例经支气管镜检查诊断为PCP复发。
急性PCP损害肺力学和气体交换。恢复过程中，气体交换缺陷持续的时间比肺容量减少的时间更长。（摘要截选于250字）
