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目的探讨艾滋病病人继发卡氏肺孢子肺炎(PCP)的诊断治疗及PCP的发生与CD4+T细胞水平之间的关系。方法对2004年4月-2007年2月诊断的34例PCP进行全面分析。结果患者中有发热、咳嗽、有呼吸困难、间断性咳嗽少痰症状的比例分别为100.00%、76.50%、85.30%、66.50%;血氧饱和度52.00%~86.00%;胸片呈间质样改变;乳酸脱氢酶(LDH)升高;CD4+T细胞极度减少(平均27/mm3);复方新诺明(SMZco)治疗反应良好且安全。结论34例艾滋病病人发生PCP时细胞免疫功能极度低下;艾滋病继发PCP的特异性诊断是病原体检查,但是典型的临床表现、胸片影像网状改变、血氧饱和度降低、LDH升高及SMZco治疗有效也可以明确诊断PCP。
Objective To investigate the diagnosis and treatment of Pneumocystis carinii pneumonia (PCP) secondary to AIDS and the relationship between the occurrence of PCP and the level of CD4 + T cells. Methods A total of 34 PCP cases diagnosed from April 2004 to February 2007 were analyzed. Results The proportion of patients with fever, cough, dyspnea and intermittent cough without sputum were 100%, 76.50%, 85.30% and 66.50% respectively; the oxygen saturation was 52.00% ~ 86.00% (LDH) increased; CD4 + T cells decreased extremely (average 27 / mm3); SMZco treatment responded well and safe. Conclusion 34 cases of AIDS patients with PCP cell immune function is extremely low; specific diagnosis of AIDS secondary PCP is pathogen examination, but the typical clinical manifestations, chest X-ray image changes, decreased oxygen saturation, elevated LDH and SMZco Effective treatment can also be a clear diagnosis of PCP.