Dohtsu Yasumasa, Ishimatsu Yuji, Takatani Hiroshi, Minami Kazunori, Inoue Keiji, Kohara Norihiro, Yanagihara Katsunori, Higashiyama Yasuhito, Miyazaki Yoshitsugu, Hirakata Yoichi, Kohno Shigeru
Department of Medicine, Nagasaki Municipal Hospital.
Kansenshogaku Zasshi. 2005 Sep;79(9):656-63. doi: 10.11150/kansenshogakuzasshi1970.79.656.
Clinical studies of sixteen cases with pulmonary cryptococcosis, during the past six years between 1998 and 2004, were peformed mainly with respect to serum cryptococcal antigen titer. Serum cryptococcal antigen was positive in twelve of 16 cases, the other three cases were diagnosed by VATS, the other one by positive culture of cryptococcus in BALF. In these twelve cases, the serum cryptococcal antigen titer was continuously tested after treatment. The serum cryptococcal antigen titer decreased from half to 6 months after treatment. And the cryptococcal Ag changed to negative in six of the 12 cases by antifungal agents from 5 to 19 months. But four cases whose pneumonia was severe tended to have a high titer level of cryptococcal antigen and were positive for a long period. In the Chest CT of four pulmonary cryptococcosis case with negative cryptococcal antigen, all of the maximum nodule size was less than or equal to 15mm in diameter.
对1998年至2004年这过去六年中16例肺隐球菌病患者进行了临床研究,主要涉及血清隐球菌抗原滴度。16例中有12例血清隐球菌抗原呈阳性,另外3例通过电视辅助胸腔镜手术(VATS)诊断,还有1例通过支气管肺泡灌洗(BALF)中隐球菌培养阳性确诊。在这12例中,治疗后持续检测血清隐球菌抗原滴度。治疗后血清隐球菌抗原滴度在半个月至6个月内下降。12例中有6例使用抗真菌药物后5至19个月隐球菌抗原转为阴性。但4例肺炎严重的患者往往隐球菌抗原滴度较高且长期呈阳性。在4例隐球菌抗原阴性的肺隐球菌病患者的胸部CT中,所有最大结节直径均小于或等于15毫米。