Qiu Lei, He Jingsong, Ye Xiujin, Xie Wanzhuo, Shi Jimin, Zheng Weiyan, Sun Jie, Zhu Xiaoli, Cai Zhen, Huang He, Lin Maofang
Department of Hematology, People's Hospital of Zhoushan, 238 North Renmin Road, Dinghai, Zhoushan, Zhejiang, People's Republic of China.
Department of Hematology and Bone Marrow Transplantation Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China.
Int J Hematol. 2009 Jul;90(1):108-112. doi: 10.1007/s12185-009-0335-0. Epub 2009 May 30.
Severe hemoptysis is the fatal complication of invasive pulmonary fungal infection (IPFI) in patients with hematologic diseases. This report retrospectively analyzed the clinical data of nine IPFI patients with hematologic diseases complicated with severe hemoptysis. Four in nine patients were diagnosed of proven IPFI, probable was established in two and the remaining were diagnosed of possible. Seven patients did not respond to the primary treatment, and four of them also did not respond to the salvage therapy. In these nine patients, seven presented massive hemoptysis and all died of that; other two patients presented severe hemoptysis. The result indicates that ineffective initial treatment and irregular therapy may underlie the concurrence of massive hemoptysis. The prognosis of IPFI patients with massive hemoptysis is very poor. Special attention for IPFI treatment should be prophylaxis, early management as well as sufficient and a whole course administration of effective broad-spectrum antifungal agents.
严重咯血是血液病患者侵袭性肺部真菌感染(IPFI)的致命并发症。本报告回顾性分析了9例血液病合并严重咯血的IPFI患者的临床资料。9例患者中4例被诊断为确诊IPFI,2例为拟诊,其余为疑似。7例患者对初始治疗无效,其中4例对挽救治疗也无效。这9例患者中,7例出现大量咯血,均死于咯血;另外2例患者出现严重咯血。结果表明,初始治疗无效和治疗不规范可能是大量咯血并发的原因。大量咯血的IPFI患者预后很差。IPFI治疗应特别注意预防、早期处理以及有效广谱抗真菌药物的充分和全程应用。