Kovacs J A, Hiemenz J W, Macher A M, Stover D, Murray H W, Shelhamer J, Lane H C, Urmacher C, Honig C, Longo D L
Ann Intern Med. 1984 May;100(5):663-71. doi: 10.7326/0003-4819-100-5-663.
Clinical features of 49 episodes of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome were compared with those of 39 episodes in patients with other immunosuppressive diseases. At presentation patients with the syndrome were found to have a longer median duration of symptoms (28 days versus 5 days, p = 0.0001), lower mean respiratory rate (23.4 versus 30, p = 0.005), and higher median room air arterial oxygen tension (69 mm Hg versus 52 mm Hg, p = 0.0002). The survival rate from 1979 to 1983 was similar for the two groups (57% and 50% respectively). Patients with the syndrome had a higher incidence of adverse reactions to trimethoprim-sulfamethoxazole (22 of 34 versus 2 of 17, p = 0.0007). Survivors with the syndrome at initial presentation had a significantly lower respiratory rate, and higher room air arterial oxygen tension, lymphocyte count, and serum albumin level compared to nonsurvivors. Pneumocystis carinii pneumonia presents as a more insidious disease process in patients with the syndrome, and drug therapy in these patients is complicated by frequent adverse reactions.
对49例获得性免疫缺陷综合征患者的卡氏肺孢子虫肺炎发作的临床特征与39例其他免疫抑制疾病患者的发作特征进行了比较。在就诊时发现，综合征患者的症状中位持续时间更长（28天对5天，p = 0.0001），平均呼吸频率更低（23.4对30，p = 0.005），且室内空气动脉血氧分压中位数更高（69毫米汞柱对52毫米汞柱，p = 0.0002）。1979年至1983年两组的生存率相似（分别为57%和50%）。综合征患者对甲氧苄啶-磺胺甲恶唑的不良反应发生率更高（34例中的22例对17例中的2例，p = 0.0007）。与非幸存者相比，初次就诊时患有综合征的幸存者呼吸频率显著更低，室内空气动脉血氧分压、淋巴细胞计数和血清白蛋白水平更高。卡氏肺孢子虫肺炎在综合征患者中表现为一种更隐匿的疾病过程，并且这些患者的药物治疗因频繁的不良反应而变得复杂。
