Kroe D M, Kirsch C M, Jensen W A
Stanford University School of Medicine, CA, USA.
Semin Respir Infect. 1997 Jun;12(2):70-8.
Pneumocystis carinii is an opportunistic organism that is a common cause of pneumonia in immunocompromised patients. Its life cycle begins when cysts rupture and release sporozoites, which mature into trophozoites that eventually form cysts. The diagnostic methods for P. carinii pneumonia (PCP) have progressed from open lung biopsy to bronchoalveolar lavage (BAL) and induced sputum analysis (ISA). Detection of P. carinii organisms is done with various stains that highlight sporozoites, trophozoites, or the cyst wall. Noninvasive, cost-effective methods to aid in the diagnosis of PCP have been proposed and include chest radiograph analysis, gallium scintigraphy, serum lactate dehydrogenase levels, CD4 lymphocyte counts, pulmonary function tests, arterial blood gas analysis, and exercise hemoglobin oxygen saturation measurements. Some investigators propose empiric treatment of PCP to reduce the number of bronchoscopies performed. Most physicians prefer to make a definitive diagnosis of PCP to ensure appropriate therapy.
卡氏肺孢子菌是一种机会性致病生物，是免疫功能低下患者肺炎的常见病因。其生命周期始于囊肿破裂并释放子孢子，子孢子成熟为滋养体，最终形成囊肿。卡氏肺孢子菌肺炎（PCP）的诊断方法已从开胸肺活检发展到支气管肺泡灌洗（BAL）和诱导痰分析（ISA）。通过各种能突出显示子孢子、滋养体或囊肿壁的染色方法来检测卡氏肺孢子菌。已经提出了有助于PCP诊断的非侵入性、成本效益高的方法，包括胸部X线片分析、镓闪烁显像、血清乳酸脱氢酶水平、CD4淋巴细胞计数、肺功能测试、动脉血气分析和运动血红蛋白氧饱和度测量。一些研究人员建议对PCP进行经验性治疗，以减少支气管镜检查的次数。大多数医生更倾向于对PCP做出明确诊断，以确保进行适当的治疗。
