TY - JOUR T1 -长期初级雾化喷脒预防突破性卡氏肺孢子虫肺炎的效果JF -欧洲呼吸杂志JO - Eur Respir J SP - 1006 LP - 1012 DO - 10.1183/09031936.96.09051006 VL - 9 IS - 5 AU - Ewig, S AU - Schafer, H AU - Rockstroh, JK AU - Pickenhain, A AU - Luderitz，B Y1 - 1996/05/01 UR - //www.qdcxjkg.com/content/9/5/1006.abstract N2 -雾化戊酰胺是一种耐受性良好的一级预防方案，用于人类免疫缺陷病毒(HIV)感染患者的卡氏肺孢子虫肺炎(PCP)。现在它通常被长期使用。因此，我们研究了长期吸入对PCP突破的影响。我们记录了1990年1月1日至1995年6月30日期间在我们机构诊断的所有确诊PCP发作的临床、免疫学、放射学和微生物学数据，以及治疗和临床病程。此外，还检索了1989年5月1日以来所有初次雾化喷他脒患者的资料。预防失败被细分为“早期”(<Or =吸入时间12个月)和“晚期”(>12个月吸入时间)的失败，并与没有任何预防的发作进行比较。30例未采取任何预防措施的患者，6例早期失败，14例晚期失败代表研究人群。 Mean +/- SD inhalation times were 4.9 +/- 4.8 and 26.3 +/- 14.1 months, respectively. No significant differences could be detected with regard to clinical presentation, severity of PCP, and in-hospital as well as long term outcome. Early as well as late prophylaxis failures had a higher incidence of upper lobe infiltrates on chest radiography (50% without prophylaxis versus 100% with early and 83% with late failure, respectively; p < 0.05). No extrapulmonary or disseminated pneumocystosis was observed in either group. The sensitivity of site-directed bronchoalveolar lavage was conserved after long-term inhalation (86% versus 100% without prophylaxis and 97% in early failure; p = NS). The severity and outcome of Pneumocystis carinii pneumonia is not altered by long-term primary aerosolized pentamidine prophylaxis. Presentation with upper lobe infiltrates is a radiographic pattern also of late failures. Bronchoalveolar lavage should, therefore, be performed using the site-directed technique in this setting. ER -