【摘要】肺隐球菌病主要发生于免疫抑制患者，有时也见于免疫正常者。临床症状缺乏特异性，以咳嗽最多见，其次为咳痰、发热、胸痛和呼吸困难。影像学表现多样，通常分为结节/团块影、片状浸润影和弥漫混合病变三种类型。免疫功能正常的患者临床症状轻，且相当一部分患者无症状，影像学表现多为结节影，感染部位局限，多不发生播散，预后好。HIV阴性免疫抑制患者往往多种症状同时存在，病情较重，影像学表现约三分之二的患者可见肺部结节内空洞，且弥漫混合病变增多，约50%的患者累及中枢神经系统。HIV感染患者罹患肺隐球菌病时病情重，常出现高热、呼吸困难、呼吸衰竭，多累及中枢神经系统，且往往为首发表现，预后差。
【关键词】肺隐球菌病; 免疫抑制患者; 人类免疫缺陷病毒
Pulmonary Cryptococcosis: Correlation Between Clinical Manifestations And Immune Status,Zhou Qing-Tao,He Bei,Peking University The Third Hospital,Beijing,100010,China
【Abstract】 Pulmonary cryptococcosis (PC) typically occurs in immunocompromised patients,but it can also occur in immunocompetent persons.Symptoms of PC are non-specific,cough is the most common symptom,followed by expectoration,fever,chest pain and dyspnea, and some patients may be asymptomatic.There are three types of radiologic abnormalities on chest computed tomography scans,including solitary or multiple pulmonary nodules/masses,patchy infiltration,and diffusing mixed lesions.The clinical manifestation of PC partly depends on immune status of patients.
【Key words】 Pulmonary cryptococcosis;Immunocompromised patient;Human immunodeficiency virus