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[副球孢子菌病:58例的放射学与肺部研究]

[Paracoccidioidomycosis: radiologic and pulmonary study in 58 cases].

作者信息

Campos E P, Padovani C R, Cataneo A M

机构信息

Depto. de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina de Botucatu, UNESP, Brasil.

出版信息

Rev Inst Med Trop Sao Paulo. 1991 Jul-Aug;33(4):267-76.

PMID:1844948
Abstract

Spirometric and haemogasimetric tests were performed in 52 patients with unifocal and multifocal progressive Paracoccidioidomycosis pulmonary diseases, in 5 patients with juvenile and 1 female internal genital forms. The age ranged from 20 to 74 years old and the duration of disease from 3 to 25 years. Dyspnea, cough, tegumentary and lymphatic manifestations were the most predominant signs observed. Fourteen of them was developed Cor pulmonale. Impaired renal function was recorded in 19 patients, cardiac symptoms were described in 7 and hyporeactor adrenal activity was showed in 13 patients. Radiological studies demonstrated mild in 16, moderate in 24 and severe pulmonary lesions types in 18 patients. The pulmonary function revealed: normal spyrographic findings in 17, pure obstructive type in 32 and mixed form in 9 of them. Hyperventilation was described in 54 individuals and all of them showed an increasing of the alveolo-arterial difference. PaO2 less than 80 mm/Hg observed in 36 of them. Statistical analysis demonstrated significative association between clinical evolution and radiological interpretation. Similar data were obtained in radiology evaluations, clinical evolutive studies and pulmonary functions described in these patients. The granulomatous reaction due to Paracoccidioidomycosis, in heavy smokers patients, gave origin to the alterations in small airways predisposing the interalveolar dissemination an impaired alveolo-arterial diffusion.

摘要

对52例患有单灶性和多灶性进行性副球孢子菌病肺部疾病的患者、5例患有青少年型和1例患有女性内生殖器型副球孢子菌病的患者进行了肺量计和血气分析测试。患者年龄在20至74岁之间,病程为3至25年。观察到的最主要症状为呼吸困难、咳嗽、皮肤和淋巴表现。其中14例发展为肺心病。19例患者记录有肾功能损害,7例描述有心脏症状,13例患者表现出肾上腺反应低下。放射学研究显示,16例患者肺部病变轻微,24例为中度,18例为重度。肺功能检查结果显示:17例患者肺量计检查结果正常,32例为单纯阻塞型,9例为混合型。54例患者出现通气过度,所有患者的肺泡-动脉血氧分压差均增大。其中36例患者的动脉血氧分压(PaO2)低于80 mmHg。统计分析表明临床进展与放射学解读之间存在显著关联。在这些患者的放射学评估、临床进展研究和肺功能检查中也获得了类似的数据。重度吸烟者中由副球孢子菌病引起的肉芽肿反应导致小气道改变,易发生肺泡间播散和肺泡-动脉扩散受损。

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