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find Keyword "侵袭性" 40 results
  • Aggressive NK/T Lymphoma with Autologous Hematopoietic Stem Cell Transplantation

    【摘要】 目的 探讨自体造血干细胞移植(autologous hematopoietic stem cell transplantation,auto-HSCT)治疗侵袭性NK/T细胞淋巴瘤的疗效。 方法 对我科2005年1月16日收治的1例侵袭性NK/T细胞淋巴瘤患者的造血干细胞移植和随访资料进行回顾性分析,并复习国内外相关文献。 结果 患者为37岁女性,诊断结外鼻型NK/T细胞淋巴瘤,系统性,经CHOAP和ICE方案化学疗法、手术、局部放射治疗控制病情良好后,采集自体骨髓造血干细胞,行auto-HSCT,预处理方案为全身放射治疗+ECy;移植+29 d造血功能即顺利重建;移植后密切随访,患者一直处于完全缓解,至今已存活67个月。 结论 auto-HSCT治疗侵袭性NK/T细胞淋巴瘤疗效肯定、可靠。【Abstract】 Objective To explore the therapeutic effect of autologous hematopoietic stem cell transplantation (auto-HSCT) on aggressive NK/T lymphoma. Methods The clinical data of one patient with aggressive NK/T lymphoma diagnosed in January 2005 were retrospectively analyzed, and the relevant domestic literatures were analyzed. Results This thirty-seven-year-old female patient had good disease control after undergoing chemotherapy with CHOAP and ICE regimens, surgery, and locoregional radiotherapy. After that, she had been collected enough bone marrow-derived hematopoietic stem cells, then underwent auto-HSCT with these cells. The conditioning regimen was TBI plus ECy. On the +29th day after transplantation,the hematopoietic reconstruction was successful. During the follow-up period, the patient was in complete remission status all along and her disease-free survival (DFS) was 67 months. Conclusion Auto-HSCT is effective on aggressive NK/T lymphoma.

    Release date:2016-08-26 02:18 Export PDF Favorites Scan
  • Invasive aspergillosis in nonneutropenic patients:risk factors,clinical features and outcome

    Objective To investigate the risk factors,clinical features and outcome of invasive aspergillosis(IA) in nonneutropenic patients.Methods Fifty-four patients with IA at the First Affiliated Hospital of Zhengzhou University from Jan 2001 to Dec 2006 were analyzed retrospectively.According to the definitions of EORTC/MSG,proven diagnosis was made in 9 cases,probable diagnosis in 30 cases and possible diagnosis in 15 cases.Results In the neutropenic group(n=24),hematological malignancies were the major underlying conditions(n=20).In nonneutropenic group(n=30),the main underlying condition was steroid-treated COPD(n=11).Fever,dyspnea,cough,chest pain and haemoptysis were commonly symptoms.Thoracic computed tomography showed that segmental consolidation occurred more frequently in neutropenic patients,whereas diffuse nodules more frequently in nonneutropenic patients.Nodules or consolidation with evidence of cavity lesion had a higher sensitivity than the halo sign or air crescent sign in both groups.The total mortality of IA was 72.2%.The mortality of nonneutropenic group was higher than that of neutropenic group(83.3% vs 58.3%,P=0.042).Multivariate analysis showed that secondary central nerves system IA and delayed diagnosis were associated with poor outcome of IA.Conclusion There were high incidence and mortality of IA among nonneutropenic patients,especially those with COPD treated with long-term corticosteroids.

    Release date:2016-09-14 11:56 Export PDF Favorites Scan
  • b>Advances in pathogenesis of invasive pulmonary aspergillosis

    曲霉在自然界中广泛分布,约20种曲霉能感染人类和动物,其中最常见的有烟曲霉、黄曲霉、土曲霉和黑曲霉等。曲霉孢子在空气中传播,人吸入后曲霉可以在气道内定植、致敏、感染,当人体免疫功能低下时可产生危及生命的侵袭性肺曲霉病(IPA)。近年来IPA发病率呈上升趋势,已成为仅次于念珠菌病的主要肺部真菌感染性疾病[1]。虽然IPA已成为器官移植受者、恶性血液病和恶性肿瘤患者等高危人群的重要死因,但对其发病机制了解甚少。本文着重论述近年来IPA发病机制的研究进展。

    Release date:2016-09-14 11:53 Export PDF Favorites Scan
  • 非血液/恶性肿瘤患者侵袭性肺曲霉病11例临床分析

    肺曲霉病是由曲霉感染或吸入曲霉病原引起的一组急慢性肺部病变,临床上一般将肺曲霉病分为曲菌球、变态反应性支气管肺曲霉病和侵袭性肺曲霉病(IPA)三种类型,其中IPA危害最大、病死率最高。现将复旦大学附属中山医院呼吸科2005年4月~2007年4月诊断的11例IPA报告如下。

    Release date:2016-09-14 11:57 Export PDF Favorites Scan
  • Risk Factors of Invasive Fungal Infection in Respiratory Ward: A Retrospective Case Control Study

    Objective To explore the risk factors of invasive fungal infection ( IFI) in respiratory ward. Methods A multi-center, retrospective, case-control study was carried out. Patients from five general hospitals in Chongqing city, diagnosed as fungal infection, or whose respiratory specimens were fungal positive, were retrospectively screened for IFI. Patients with respiratory infection and colonization of nonfungal cases in the same period of hospitalization were enrolled as control. Results Thirty-four patients diagnosed with IFI and 50 patients diagnosed with bacterial infection were analyzed for the risk factors of IFI. The demographic characteristics of patients including age and gender were not different( P gt; 0. 05) , but hospitalization days, carbapenem antibiotic use, chemotherapy, deep venous catheterization, total parenteralnutrition( TPN) , neutropenia, and renal disfunction were different significantly between the IFI group and the control group. Multiple logistic regression analysis showed that carbapenem antibiotic use ( OR = 6. 753) ,central venous catheterization ( OR = 5. 021) and TPN ( OR = 3. 199) were main risk factors of invasive fungal infection. Conclusion The carbapenem antibiotic use, central venous catheterization and TPN are risk factors for IFI in respiratory ward.

    Release date:2016-09-14 11:25 Export PDF Favorites Scan
  • 侵袭性肺曲霉菌感染诊治进展

    随着社会老龄化, 抗肿瘤药物、免疫抑制剂和器官移植等治疗的广泛开展, 在危重患者中广谱抗生素药物的长期应用, 与之伴随的是真菌感染发生的逐年增多, 其中侵袭性曲霉菌感染因其感染隐匿, 难以诊治和高死亡率等特点被临床医生所重视。按我国医院感染监控网分析, 医院真菌感染率从1993 ~1996 年的13. 9% 上升至1998 ~1999 年的17. 1% 、1999 ~2000 年的24. 4% 。侵袭曲霉菌病特别是肺部曲霉菌感染多发生在有严重基础疾病的患者,预后差, 病死率达50% ~100% [ 1 ] 。本文回顾相关研究文献中关于侵袭性肺曲霉菌诊治进展, 高危人群, 目前诊断检测技术的临床价值, 抗曲霉菌药物特点和治疗现状。

    Release date:2016-08-30 11:56 Export PDF Favorites Scan
  • Efficacy and Safety of Inhaled Amphotericin B in Prophylaxis of Invasive Pulmonary Aspergillosis: A Meta-analysis

    Objective To evaluate the efficacy and safety of inhaled amphotericin B ( AmB) in prophylaxis of invasive pulmonary aspergillosis ( IPA) in both animal studies and clinical researches. Methods MEDLINE, ISI, EMBASE and Wanfang Periodical Databases were searched until march 2011 for case-control study on the efficacy and safety of inhaled AmB in prophylaxis of IPA. The articles were evaluated according to inclusion criteria. Poor-quality studies were excluded, and RevMan 4. 22 sofeware was applied for investigating the heterogeneity among individual studies and calculating the pooled odds ratio ( OR) and 95% confidence interval ( CI) . Results Five animal studies with a total of 626 animals were included. The overall survival rate of the immunosuppressed animals with pulmonary aspergillosis treated with nebulized AmB was increased ( 38.3% vs. 9.7% , OR=13.93, 95% CI 7.46 ~26.01, Plt;0. 000 01) . Six clinical trials including 1354 patients were considered. Our meta-analysis showed that inhaled AmB could significantly reduce the incidence rate of IPA ( 2.6% vs. 9.2% , OR=0.27, 95% CI 0.16 ~0.46, P lt;0. 000 01) , but had no definite benefit on mortality. Four studies evaluated the potential side effects of nebulized AmB and showed that there were no significant adverse events. Conclusions Empirical inhaled AmB is associated with a lower rate of IPA but no significant

    Release date:2016-09-13 04:00 Export PDF Favorites Scan
  • 联合检测半乳甘露聚糖和(1→3)-β-D葡聚糖在诊治侵袭性曲霉菌感染中的研究进展

    近年随着广谱抗生素和免疫抑制剂的使用,侵袭性真菌感染(invasive fungal disease,IFD)的发病率逐年上升。其中侵袭性曲霉病(invasive aspergillosis,IA)在IFD中比例逐年增高。侵袭性曲霉菌感染在血液科和重症加强治疗病房(ICU)最为常见,其次为呼吸内科、感染科和免疫科,IA为免疫功能低下患者致死率高的主要原因,造血干细胞移植(HSCT)患者中IA的发病率为2%~26%,在血液病和造血干细胞移植患者中IA死亡率高达70.0%~90.0%。造成死亡率高的主要原因是在病程早期不能对IA进行可靠诊断,往往使患者延误治疗而死亡。因此,选择正确、合适的早期诊断方法对疾病的预后具有决定性意义。传统的诊断方法如影像学、真菌直接镜检、培养及组织病理学检查的敏感性不高,检出率低,难以用于早期诊断。因此,新的诊断方法对IA的治疗至关重要。血清学诊断方法是应用免疫和生化方法检测血清或其他体液中的真菌细胞壁和胞质成分,分为抗原和抗体检查两类。但由于IFD多继发于严重免疫受损患者,往往缺乏可检测到的抗体,或者抗体的产生变化较大,因此以检测真菌抗原为主。目前半乳甘露聚糖(GM)和(1→3)-β-D葡聚糖(BG)成为真菌检查中非常重要的两个抗原。

    Release date:2016-08-30 11:58 Export PDF Favorites Scan
  • 重症甲型H1N1流感肺炎合并侵袭性真菌感染的诊治体会

    Release date:2016-09-13 04:00 Export PDF Favorites Scan
  • Clinical and Etiology Research of Invasive Pulmonary Fungal Disease

    Objective To summarize the clinical features, predisposing factors, diagnosis, therapeutic outcome, and prognosis of invasive pulmonary fungal infection( IPFI) . Methods 90 cases with pathologically proved IPFI, admitted in non-intensive care unit in Xiangya Hospital from January 2005 to February 2012, were retrospectively analyzed. Results The pathogenic examination revealed Aspergillosis in 56 cases( 62. 2% ) , Cryptococcus in 18 cases( 20. 0% ) , Mucormycosis in 6 cases( 6. 7% ) , and Histoplasma in 6 cases( 6. 7% ) , etc. The underlying diseases were reported in 87 cases, and mainly included COPD, pulmonary tuberculosis, and diabetes mellitus. Cough and expectoration were the common clinical symptoms. 49 patients ( 54. 4% ) received long-term and broad-spectrum antibiotic therapy. The CT results revealed masses type in 25 cases( 27. 8%) , nodule lesions type in 15 cases( 16. 7% ) , lung consolidation type in 22 cases( 24. 4% ) , cavity type in 22 cases( 24. 4% ) , aspergilloma type in 6 cases( 6. 7% ) . 47 patients were clinical diagnosed with IPFI before biopsy with preliminary diagnosis accordance rate of 52. 2% . 31 cases ( 34. 4% ) underwent surgical resection of pulmonary lesions, and no recurrence was detected over two-year follow up. 56 cases ( 62. 2% ) received systemic anti-fugal therapy, and 43 cases( 76. 8% ) were cured or significantly improved. 3 cases ( 3. 3% ) refused any therapy. Conclusions The most frequently isolated pathogen of IPFI is Aspergillosis. The mainly underlying diseases are COPD, pulmonary tuberculosis, and diabetes mellitus. Long-termand broad-spectrum antibiotic therapy may be the major risk factor. Pathological examination is needed for final diagnosis. Surgical procedure can achieve optimal prognosis.

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