Clinical analysis of 23 cases of Pneumocystis pneumonia in patients with acquired immunodeficiency syndrome / 中国感染控制杂志

ABSTRACT

Objective To investigate the clinical characteristics,diagnosis and therapeutic prognosis of Pneumocystis pneumonia(PCP)in patients with acquired immunodeficiency syndrome (AIDS).Methods AIDS patients with PCP were searched through computer medical record information system,clinical data were analyzed retrospectively,patients were divided into respiratory failure group (n= 1 1 )and non-respiratory failure group (n= 1 2 ),partial pressure of oxygen in arterial blood(PaO2 ),degree of blood oxygen saturation(SaO2 ),CD4+T lymphocyte,and lactate dehydrogenase(LDH) between two groups were compared. Results 23 patients generally had the symptoms of weight loss,oral leukoplakia, shortness of breath,dyspnea,fever,cough,and expectoration. PaO2 value in 23 patients was (78.65±30.85)mmHg,partial pressure of carbon dioxide(PaCO2)was (24.42±5.60)mmHg,pH value was(7.43±0.79),SaO2 was (91.16±9.55)% ;SaO2 and PaO2 in respiratory failure group was lower than non-respiratory failure group,the difference was significant (both P<0.05).Lung computed tomography (CT)scans showed bilateral pulmonary ground-glass-like change. 21 patients used compound sulfamethoxazole tablets,1 patient used compound sulfamethoxazole tablets plus clindamycin,1 patient used only clindamycin,17 patients used glucocorticoid in addition to compound sulfamethoxazole;after treatment,20 patients improved,2 died,and 1 gave up treatment.Conclusion Subacute progressive dyspnea,fever,dry cough,and lung ground-glass-like shadow are common symptoms of PCP in AIDS patients,compound sulfamethoxazole or compound sulfamethoxazole with clindamycin can be used for treatment,glucocorticoid can obviously alleviate the symptoms of patients.