免疫抑制患者重症肺炎
Immunosuppressive Patients with Severe Pneumonia
DOI: 10.12677/ACM.2023.134877, PDF,   
作者: 郭孟亚, 徐思成:新疆医科大学第一附属医院呼吸危重症医学科,新疆 乌鲁木齐
关键词: 免疫抑制患者重症肺炎临床诊断病原体诊断治疗Immunosuppressed Patients Severe Pneumonia Clinical Diagnosis Pathogen Diagnosis Treatment
摘要: 目前,免疫抑制患者并发重症肺炎的趋势逐渐上升,多系统累及且病情进展快。其临床症状及影像学表现随免疫抑制程度、类型及感染病原体各异,确切的病原体诊断和及时的支持治疗也必不可少。本文主要从免疫抑制患者重症肺炎的免疫类型与感染病原体、临床诊断、病原体诊断及治疗方面进行论述。
Abstract: At present, the trend of severe pneumonia in immunosuppressed patients is gradually increasing, and multiple systems are involved and the disease progresses rapidly. Its clinical symptoms and imaging manifestations vary with the degree of immunosuppression, type, and infectious pathogen, and accurate pathogen diagnosis and timely supportive care are also essential. This article mainly discusses the immune types and infectious pathogens, clinical diagnosis, pathogen diagnosis and treatment of severe pneumonia in immunosuppressed patients.
文章引用:郭孟亚, 徐思成. 免疫抑制患者重症肺炎[J]. 临床医学进展, 2023, 13(4): 6230-6235. https://doi.org/10.12677/ACM.2023.134877

参考文献

[1] Di Pasquale, M.F., Sotgiu, G., Gramegna, A., et al. (2019) Prevalence and Etiology of Community-Acquired Pneumonia in Immunocompromised Patients. Clinical Infectious Diseases, 68, 1482-1493. [Google Scholar] [CrossRef] [PubMed]
[2] Van de Louw, A., Mirouse, A., Peyrony, O., Lemiale, V. and Azoulay, E. (2019) Bacterial Pneumonias in Immunocompromised Patients. Seminars in Respiratory and Critical Care Medicine, 40, 498-507. [Google Scholar] [CrossRef] [PubMed]
[3] Rali, P., Veer, M., Gupta, N., et al. (2016) Opportunistic Pulmonary Infections in Immunocompromised Hosts. Critical Care Nursing Quarterly, 39, 161-175. [Google Scholar] [CrossRef
[4] Yang, L., He, D., Huang, D., Zhang, Z. and Liang, Z. (2022) Development and Validation of Nomogram for Hospital Mortality in Immunocompromised Patients with Severe Pneumonia in Intensive Care Units: A Single-Center, Retrospective Cohort Study. International Journal of General Medicine, 15, 451-463. [Google Scholar] [CrossRef
[5] Aliberti, S., Dela Cruz, C.S., Amati, F., Sotgiu, G. and Restrepo, M.I. (2021) Community-Acquired Pneumonia. Lancet, 398, 906-919. [Google Scholar] [CrossRef
[6] Dalhoff, K., Marxsen, J. and Steinhoff, J. (2007) Pneumonien bei Immunsuppression. Der Internist, 48, 507-518. [Google Scholar] [CrossRef] [PubMed]
[7] Pappas, P.G., Alexander, B.D., Andes, D.R., et al. (2010) Inva-sive Fungal Infections among Organ Transplant Recipients: Results of the Transplant-Associated Infection Surveillance Network (TRANSNET). Clinical Infectious Diseases, 50, 1101-1111. [Google Scholar] [CrossRef] [PubMed]
[8] Pardo, E., Lemiale, V., Mokart, D., et al. (2019) Invasive Pulmonary Aspergillosis in Critically Ill Patients With Hematological Malignancies. Intensive Care Medicine, 45, 1732-1741. [Google Scholar] [CrossRef] [PubMed]
[9] (2009) Pneumonia in Immunocompromised Patients. Respirology, 14, S44-S50. [Google Scholar] [CrossRef] [PubMed]
[10] Hamilton, C.D. (2005) Immunosuppression Related to Collagen-Vascular Disease or Its Treatment. Proceedings of the American Thoracic Society, 2, 456-460. [Google Scholar] [CrossRef
[11] Brigden, M.L. and Pattullo, A.L. (1999) Prevention and Man-agement of Overwhelming Postsplenectomy Infection—An Update. Critical Care Medicine, 27, 836-842. [Google Scholar] [CrossRef] [PubMed]
[12] 瞿介明. 免疫妥协宿主肺部感染——我国免疫抑制患者肺部感染诊治困惑及其剖析[J]. 中国实用内科杂志, 2009, 29(8): 685-686.
[13] Azoulay, E., Pickkers, P., Soares, M., et al. (2017) Acute Hypoxemic Respiratory Failure in Immunocompromised Patients: The Efraim Multina-tional Prospective Cohort Study. Intensive Care Medicine, 43, 1808-1819. [Google Scholar] [CrossRef] [PubMed]
[14] 范思佳, 孙霓, 张永飞, 等. 恶性肿瘤化疗后肺部感染患者并发持续炎症-免疫抑制-分解代谢综合征的危险因素及预后分析[J]. 肿瘤研究与临床, 2019, 31(3): 172-175.
[15] 于婧, 宫小薇, 赵靖, 等. 非HIV免疫抑制患者合并重症肺炎的临床特点及预后因素[J]. 国际呼吸杂志, 2019, 39(19): 1467-1474.
[16] Grover, S.B., Grover, H., Antil, N., et al. (2022) Imaging Approach to Pulmonary Infections in the Immunocompromised Patient. The Indian Journal of Radiology & Imaging, 32, 81-112. [Google Scholar] [CrossRef] [PubMed]
[17] Azoulay, E., Russell, L., Van de Louw, A., et al. (2020) Diagnosis of Severe Respiratory Infections in Immunocompromised Patients. Intensive Care Medicine, 46, 298-314. [Google Scholar] [CrossRef] [PubMed]
[18] Nachiappan, A.C., Rahbar, K., Shi, X., et al. (2017) Pulmonary Tuberculosis: Role of Radiology in Diagnosis and Management. Radiographics, 37, 52-72. [Google Scholar] [CrossRef] [PubMed]
[19] Lletí, M.S., Navalón, M.D.C., Pitarch, M.T. and García-Bustos, V. (2022) Etiology, Diagnosis, and Management of Pneumonia in Immunosuppressed Patients. Revista Espanola de Quimioterapia, 35, 89-96. [Google Scholar] [CrossRef] [PubMed]
[20] 中国医师协会急诊医师分会. 中国急诊重症肺炎临床实践专家共识[J]. 中国急救医学, 2016, 36(2): 97-107.
[21] 瞿介明, 何礼贤. 免疫抑制患者并发肺结核的诊断探讨[J]. 上海医科大学学报, 1994, 21(1): 23-26.
[22] 徐翠萍, 张波. 支气管肺泡灌洗在免疫抑制患者肺部感染中的诊断价值[J]. 国际呼吸杂志, 2014, 34(6): 455-460.
[23] 方余, 张频捷, 杨翔, 等. 支气管肺泡灌洗液G试验及GM试验对侵袭性肺部真菌感染的早期诊断价值[J]. 中国急救医学, 2019, 39(9): 827-831.
[24] Acosta, J., Catalan, M., Del Palacio-Peréz-Medel, A., et al. (2011) A Prospective Comparison of Galactomannan in Bronchoalveolar Lavage Fluid for the Diagnosis of Pulmonary Invasive Aspergillosis in Medical Patients under Intensive Care: Comparison With the Diagnostic Performance of Galactomannan and of (1→3)-β-d-Glucan Chromogenic Assay in Serum Samples. Clinical Microbiology and Infection, 17, 1053-1060. [Google Scholar] [CrossRef] [PubMed]
[25] Shen, B., Yi, X., Sun, Y., et al. (2020) Proteomic and Metabolomic Characterization of COVID-19 Patient Sera. Cell, 182, 59-72. [Google Scholar] [CrossRef] [PubMed]
[26] Walter, J.M. and Wunderink, R.G. (2018) Testing for Respiratory Viruses in Adults With Severe Lower Respiratory Infection. CHEST, 154, 1213-1222. [Google Scholar] [CrossRef] [PubMed]
[27] Agustí, C., Rañó, A., Filella, X., et al. (2003) Pulmonary Infil-trates in Patients Receiving Long-Term Glucocorticoid Treatment: Etiology, Prognostic Factors, and Associated In-flammatory Response. CHEST, 123, 488-498. [Google Scholar] [CrossRef] [PubMed]
[28] Li, L., Hsu, S.H., Gu, X., et al. (2020) Aetiology and Prognostic Risk Factors of Mortality in Patients With Pneumonia Receiving Glucocorticoids Alone or Glucocorticoids and Other Immunosuppressants: A Retrospective Cohort Study. BMJ Open, 10, e037419. [Google Scholar] [CrossRef] [PubMed]
[29] 何权瀛, 张波. 应高度重视免疫功能低下患者的肺部感染[J]. 中华结核和呼吸杂志, 2010, 33(10): 721-722.
[30] Qureshi, S., Pandey, A., Sirohi, T.R., et al. (2014) Mixed Pulmonary Infection in an Immunocompromised Patient: A Rare Case Report. Indian Journal of Medical Microbiology, 32, 79-81. [Google Scholar] [CrossRef] [PubMed]
[31] 王军. 无创呼吸机联合有创机械通气治疗呼吸衰竭的效果观察[J]. 基层医学论坛, 2020, 24(2): 182-183.
[32] 李蕾, 闫登峰. 有创-无创序贯机械通气在重症肺炎治疗中的应用[J]. 江苏医药, 2016, 42(4): 464-465.