目的 了解非中性粒細(xì)胞缺乏患者發(fā)生侵襲性曲霉?。↖A）的危險(xiǎn)因素、臨床特征及預(yù)后。方法 根據(jù)歐洲癌癥研究和治療侵襲性真菌感染協(xié)作組以及美國(guó)變態(tài)反應(yīng)和感染性疾病學(xué)會(huì)真菌病研究組（EORTC/MSG）2002年的定義及我國(guó)侵襲性肺曲霉病的分級(jí)診斷標(biāo)準(zhǔn)，納入鄭州大學(xué)第一附屬醫(yī)院2001年1月~2006年12月診斷的54例IA患者（其中確診9例，臨床診斷30例，擬診15例），進(jìn)行回顧性分析。結(jié)果 中性粒細(xì)胞缺乏組24例，其中20例為血液系統(tǒng)惡性腫瘤患者；非中性粒細(xì)胞缺乏組30例，11例為接受激素治療的慢性阻塞性肺疾?。–OPD）患者。發(fā)熱、胸悶、咳嗽、胸痛、咯血為常見(jiàn)癥狀。胸部CT顯示節(jié)段性肺實(shí)變?cè)谥行粤＜?xì)胞缺乏組多見(jiàn)，非中性粒細(xì)胞缺乏組則以多發(fā)結(jié)節(jié)陰影為主。結(jié)節(jié)或?qū)嵶冇皟?nèi)空洞形成較暈輪征、新月征更常見(jiàn)。IA總體病死率達(dá)72.2%，非中性粒細(xì)胞缺乏組高于中性粒細(xì)胞缺乏組（83.3%比58.3%，P=0.042）。預(yù)后危險(xiǎn)因素分析表明，繼發(fā)中樞神經(jīng)系統(tǒng)IA及延遲診斷與預(yù)后有關(guān)。結(jié)論 非中性粒細(xì)胞缺乏患者發(fā)生IA并非少見(jiàn)，病死率高，接受激素治療的COPD患者是發(fā)生IA的主要危險(xiǎn)因素。
引用本文： 陳瑞英,靳建軍,歐陽(yáng)松云,孫培宗. 非中性粒細(xì)胞缺乏患者發(fā)生侵襲性曲霉病的危險(xiǎn)因素、臨床特征及預(yù)后分析. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2008, 08(3): 169-173. doi: 復(fù)制
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| 6. | 朱小敏，周新.侵襲性肺曲霉病的診斷與治療.中國(guó)呼吸與危重監(jiān)護(hù)雜志，2005，4：316-320. |
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| 12. | Clancy CJ，Nguyen MH.Acute community-acquired pneumonia due to Aspergillus in presumably immunocompetent hosts：clues for recognition of a rare but fatal disease.Chest，1998，114：629-634. |
| 13. | Denning DW：Aspergillus species.In Principles and Practice of Infectious Disease Edited by：Mandell G，Douglas J，Bennett D.Philadelphia：Churchill Livingstone：2000：2675-2685. |
| 14. | Yu VL，Muder RR，Poorsattar A.Significance of isolation of Aspergillus from the respiratory tract in diagnosis of invasive pulmonary aspergillosis.Results from a three-year prospective study.Am J Med，1986，81：249-254. |
- 1. Vaideeswar P，Prasad S，Deshpande JR，et al.Invasive pulmonary aspergillosis：A study of 39 cases at autopsy.J Postgrad Med，2004，50：21-26.
- 2. Patterson TF，Kirkpatrick WR，White M，et al.Invasive aspergillosis.Disease spectrum，treatment practices，and outcome.13 Aspergillus Study Group.Medicine（Baltimore），2000，79：250-260.
- 3. Ader F，Nseir S，Le Berre R，et al.Invasive pulmonary aspergillosis in chronic obstructive pulmonary disease：an emerging fungal pathogen.Clin Microbiol Infect，2005，11：427-429.
- 4. Denning DW.Aspergillosis in “nonimmunocompromised” critically ill patients.Am J Respir Crit Care Med，2004，170：580-581.
- 5. Ascioglu S，Rex JH，de Pauw B，et al.Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants：an international consensus.Clin Infect Dis，2002，34：7-14.
- 6. 朱小敏，周新.侵襲性肺曲霉病的診斷與治療.中國(guó)呼吸與危重監(jiān)護(hù)雜志，2005，4：316-320.
- 7. Allam MF，Del Castillo AS，Diaz-Molina C，et al.Invasive pulmonary aspergillosis：identification of risk factors.Scand J Infect Dis，2002，34：819-822.
- 8. Bulpa PA，Dive AM，Garrino MG，et al.Chronic obstructive pulmonary disease patients with invasive pulmonary aspergillosis：benefits of intensive care? Intensive Care Med，2001，27：59-67.
- 9. Rello J，Esandi ME，Mariscal D，et al.Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease：report of eight cases and review.Clin Infect Dis，1998，26：1473-1475.
- 10. Garcés Jarque JM，Terradas Robledo R，Alvarez-Lerma F，et al.Lung aspergillosis.Role of the corticoids as associated risk factor in the patient with chronic bronchitis.Rev Clin Esp，2003，203：472-474.
- 11. 陳瑞英，孫培宗，靳建軍，等.原發(fā)性侵襲性肺曲霉病四例分析.中國(guó)呼吸與危重監(jiān)護(hù)雜志，2007，6，385-387.
- 12. Clancy CJ，Nguyen MH.Acute community-acquired pneumonia due to Aspergillus in presumably immunocompetent hosts：clues for recognition of a rare but fatal disease.Chest，1998，114：629-634.
- 13. Denning DW：Aspergillus species.In Principles and Practice of Infectious Disease Edited by：Mandell G，Douglas J，Bennett D.Philadelphia：Churchill Livingstone：2000：2675-2685.
- 14. Yu VL，Muder RR，Poorsattar A.Significance of isolation of Aspergillus from the respiratory tract in diagnosis of invasive pulmonary aspergillosis.Results from a three-year prospective study.Am J Med，1986，81：249-254.