关键词：卡氏肺囊虫肺炎；诊断
【摘要】 目的 提高对卡氏肺囊虫肺炎(PCP)的认识。方法 回顾性分析6例PCP患者资料。结果 6例PCP基础疾病为白血病、淋巴瘤、肾移植和溶血性贫血。临床表现为呼吸困难、咳嗽和发热。X线表现为双肺弥漫性肺泡性或间质性改变或无改变。治疗首选复方新诺明(SMZco)和氨苯砜。3例并发呼吸衰竭，表现与成人呼吸窘迫综合征(ARDS)相似的低氧血症、肺内分流和顺应性下降。持续气道正压通气/呼气末正压通气(CPAP/PEEP)为常用模式。顽固性低氧血症可试用高水平(>1.47kPa)PEEP治疗。结论 卡氏肺囊虫肺炎并发急性呼吸衰竭者预后差，争取早期诊断与治疗是提高生存率的关键。
A clinical study of six cases of pneumocystis carinii pneumonia Wu Shixiu, Lin Xifang. Department of internal Medicine, The First Affiliated Hospital,Wenzhou Medical College, Wenzhou 325000
【Abstract】 Objective To heighten the awareness ofpneumocystis carinii pneumonia. Method Six cases of pneumocystiscarinii pneumonia were retrospectively analyzed. Result The underlyingdiseases were leukemia, lymphoma, renal transplantation and autoimmune hemolytic anemia.The clinical features were dyspnea, cough and fever. X rays typically showed a bilateraldiffuse or patchy interstitial infiltrate. Three cases complicated with acute respiratoryfailure showed hypoxemia, intrapulmonary shunt and reduced compliance resembling ARDS. CPAP/PEEP was required. High-level PEEP (>1.47 kPa) can be applied to the refractoryhypoxemia. SMZco and dapsone were the initial choice of treatment. Conclusion Theprognosis of pneumocystis carinii pneumonia with acute respiratory failure was poor.Aggressive early diagnosis and treatment were critical to improve survival.
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