Enomoto Tatsuji, Azuma Arata, Matsumoto Aki, Nei Takahito, Hiramatsu Kumiko, Abe Shinji, Usuki Jiro, Kudoh Shoji
Department of Respiratory Medicine, Tokyo Metropolitan Hiroo General Hospital.
Nihon Kokyuki Gakkai Zasshi. 2005 Dec;43(12):725-30.
We evaluated the clinical features of pneumocystis jiroveci pneumonia (PCP) as a complication of glucocorticoid therapy for interstitial pneumonia We analyzed 74 interstitial pneumonia patients receiving glucocorticoid therapy, of whom 7 patients developed PCP. At the time of PCP diagnosis, the average duration of the glucocorticoid therapy was 71 days and the average daily dose of predonisolone was 37 mg. Circulating CD4+ lymphocyte counts were 370/microl on the average and more than 200/microl in three cases. PCP cases showed less circulating lymphocyte counts four weeks after the initiation of the therapy. Any cases receiving sulfamethoxazole-trimethoprim (TMP-SMX) did not develop PCP. In conclusion, interstitial pneumonia patients, who are treated with glucocorticoid, are benefit from TMP-SMX as PCP prophylaxis, but CD4 + lymphocyte counts greater than 200/microl is no reason to denying PCP.
我们评估了作为间质性肺炎糖皮质激素治疗并发症的耶氏肺孢子菌肺炎（PCP）的临床特征。我们分析了74例接受糖皮质激素治疗的间质性肺炎患者，其中7例发生了PCP。在PCP诊断时，糖皮质激素治疗的平均持续时间为71天，泼尼松龙的平均每日剂量为37毫克。循环CD4+淋巴细胞计数平均为370/微升，3例超过200/微升。PCP病例在治疗开始四周后循环淋巴细胞计数较少。任何接受磺胺甲恶唑-甲氧苄啶（TMP-SMX）治疗的病例均未发生PCP。总之，接受糖皮质激素治疗的间质性肺炎患者受益于TMP-SMX预防PCP，但CD4+淋巴细胞计数大于200/微升并非拒绝预防PCP的理由。
