Abe Y, Shioya S, Kijima H, Nakamura M, Murata T, Sugiura M, Tamaoki N
Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Sep;31(9):1075-80.
A retrospective study was conducted to evaluate the prognostic factors in patients with Pneumocystis carinii pneumonia (PCP). From 1976 through 1991, a total of 10 PCP cases were pathologically diagnosed of our hospital. All patients were immunocompromised hosts treated with corticosteroids and/or cytotoxic drugs for their underlying diseases of malignancy in 6 and autoimmune disease in 4. The frequent symptoms in the early stage of PCP were fever in 9 and dry cough in 4 patients. The chest X-ray exhibited bilateral diffuse infiltrates in all patients. In 3 patients, the infiltrates which were localized at the early stage progressed rapidly to both lungs in a few days. All of the 3 patients in 1970-79 were diagnosed by autopsy without effective treatment. Four of the 5 patients in 1980-89 were diagnosed by autopsy or necropsy and one patient was diagnosed by transbronchial lung biopsy (TBLB). All the 5 patients in 1980-89, including 3 patients treated with sulfamethoxazole and trimethoprim (ST), died. Two patients in 1990-93 who were diagnosed by examination of TBLB or sputum specimen recovered from PCP following treatment with ST. These results indicate that the early diagnosis of PCP by the development of diagnostic techniques followed by effective treatment with anti-PCP drugs has greatly improved the outcome of PCP.
进行了一项回顾性研究，以评估卡氏肺孢子虫肺炎（PCP）患者的预后因素。1976年至1991年期间，我院共有10例PCP病例经病理诊断。所有患者均为免疫功能低下宿主，其中6例因恶性肿瘤基础疾病接受皮质类固醇和/或细胞毒性药物治疗，4例因自身免疫性疾病接受治疗。PCP早期常见症状为9例发热，4例干咳。所有患者胸部X线均显示双侧弥漫性浸润。3例患者早期局限性浸润在数天内迅速进展至双肺。1970 - 1979年的3例患者均未经有效治疗，通过尸检确诊。1980 - 1989年的5例患者中，4例通过尸检或病理解剖确诊，1例通过经支气管肺活检（TBLB）确诊。1980 - 1989年的所有5例患者，包括3例接受磺胺甲恶唑和甲氧苄啶（ST）治疗的患者，均死亡。1990 - 1993年的2例患者通过TBLB检查或痰标本确诊，经ST治疗后从PCP中康复。这些结果表明，随着诊断技术的发展实现PCP的早期诊断，并随后用抗PCP药物进行有效治疗，已大大改善了PCP的治疗结果。
