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[纤维支气管镜检查在诊断HIV相关感染中的价值]

[The value of fiberoptic bronchoscopy in diagnosis of HIV associated infections].

作者信息

Fischer B, Elmer M, Ramadori G, Lorenz J

机构信息

III. Medizinische Klinik und Poliklinik, Universitätskliniken Mainz.

出版信息

Med Klin (Munich). 1990 Jun 15;85(6):361-5.

PMID:2377146
Abstract

32 patients with HIV infection presenting with fever or abnormal chest radiograph or both were investigated at the University Hospital of Mainz (FRG). Fiberoptic bronchoscopy with bronchoalveolar lavage and transbronchial biopsy was undertaken in each patient, additionally other methods were used for isolating pathogens (i.e. urine sample, stool and blood culture etc.). In 26 patients one or more complicating diseases were documented, in six persons no reason for fever or pulmonary symptoms could be detected. 21 patients had a pulmonary complication, 13 were found to have pneumocystis carinii pneumonia. Bacterial lung diseases were diagnosed in seven individuals (three caused by M. tuberculosis, two by S. pneumoniae, one by E. cloacae and one by S. aureus). One nonspecific interstitial pneumonitis was diagnosed. By other diagnostic procedures 25 non-pulmonary complications were established. -Fiberoptic bronchoscopy is most accurate for the detection of pulmonary pathogens in HIV infected persons when transbronchial biopsy and bronchoalveolar lavage is combined, especially in pneumocystis carinii pneumonia. Bronchoscopy should be performed also if the chest radiograph is normal.

摘要

32例出现发热或胸部X光片异常或两者皆有的HIV感染者在美因茨大学医院(联邦德国)接受了检查。对每位患者进行了纤维支气管镜检查并进行支气管肺泡灌洗和经支气管活检,此外还采用了其他方法分离病原体(如尿液样本、粪便和血液培养等)。26例患者记录有1种或多种并发疾病,6例未发现发热或肺部症状的原因。21例患者有肺部并发症,13例被发现患有卡氏肺孢子虫肺炎。7例诊断为细菌性肺部疾病(3例由结核分枝杆菌引起,2例由肺炎链球菌引起,1例由阴沟肠杆菌引起,1例由金黄色葡萄球菌引起)。诊断出1例非特异性间质性肺炎。通过其他诊断程序确定了25例非肺部并发症。——当联合经支气管活检和支气管肺泡灌洗时,纤维支气管镜检查对于检测HIV感染者的肺部病原体最为准确,尤其是在卡氏肺孢子虫肺炎中。即使胸部X光片正常,也应进行支气管镜检查。

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