Résumé
Objective:To explore the risk factors of Pneumocystis carinii pneumonia (PCP) after orthotopic liver transplantation (OLT), and optimize the treatment strategy. Methods:From May 2015 to March 2019, patients undergoing OLT and suffering from postoperative PCP were selected into PCP group ( n=8). Using the propensity score matching method, controls without postoperative PCP were selected from concurrent OLT patients at a ratio of 1: 4 ( n=32). Clinical data were collected and counted for analyzing the risk factors of PCP post-OLT. Results:During this period, 385 cases of OLT were performed. The incidence of PCP was 2.1% (8/385). PCP group were all males with an average age of (52.63±12.99)(27-69) years. PCP has an average onset time of (19.88±13.22)(9-50) weeks post-OLT. There were benign liver disease ( n=2) and malignant liver tumor ( n=6). All operative approaches were modified camel OLT. Univariate analysis revealed significant differences in rejection, peripheral blood lymphocyte count and percentage of peripheral blood lymphocyte after OLT ( P<0.05) and no significant differences existed in other factors ( P>0.05). Logistic regression analysis indicated that a lower count of peripheral blood lymphocyte post-OLT was an independent risk factor for postoperative PCP. Conclusions:A lower count of peripheral blood lymphocyte post-OLT elevates the risk of PCP. For high-risk patients, prophylaxis with TMP-SMX (trimethoprim-sulfamethoxazole) may effectively lower the incidence of PCP post-OLT.
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OBJECTIVE To explore the correlation between Pneumocystic carinii pneumonia(PCP) in HIV/AIDS and CD4+T-lymphocyte level.METHODS Totally 300 cases from more than 10 000 HIV/AIDS patients who were taken chest X-ray were sampled randomly.According to count of CD4+T-lymphocyte number,300 cases were divided into 2 groups: the count of CD4+T-lymphocyte number over than 200/mm3 was group A,while the other was group B.Analysis and comparison of lung complications in HIV/AIDS and follow-up survey of PCP curative effect in these 2 groups were done.RESULTS PTB,PCP,bacterial pneumonia Kaposi sarcoma(KS) and other lung ailmentd were the most common lung complications in HIV/AIDS.There were more lung complications and worse effect of PCP therapy in group B.There was significantly difference in group A and group B(P
Résumé
We report a case of pneumonia in 36 year-old male patient who presented acute respiratory failure and associated radiologic findings of bilateral ground-glass opacity with focal cystic changes, showing rapidly aggravating course and was diagnosed as concomitant Pneumocystis carinii and Cytomegalovirus pneumonia accompanied by acquired immunodeficiency syndrome through antemortem open lung biopsy.