COPD合并侵袭性肺曲霉感染PPT学习教案

1、会计学1COPD合并侵袭性肺曲霉感染合并侵袭性肺曲霉感染第1页/共42页第2页/共42页Anthonisen（1987年）年）第3页/共42页AECOPD的定义的定义 2第4页/共42页 8080% % 感染感染 20% 非感染第5页/共42页球菌、其他革兰阳性菌，占球菌、其他革兰阳性菌，占10%-15%第6页/共42页第7页/共42页第8页/共42页IPA伴血管侵犯伴血管侵犯IPA无血管侵犯无血管侵犯慢性侵袭性慢性侵袭性菌丝侵犯组织菌丝侵犯组织肺曲菌病的慢性形式肺曲菌病的慢性形式第9页/共42页第10页/共42页COPDCOPD合并合并IPAIPA的病因及机制的病因及机制第11页/共42页牛

2、颖梅,童朝晖.慢性阻塞性肺疾病合并侵袭性肺曲霉病的研究进展.中华结核和呼吸杂志2009年4月第32卷第4期295-297第12页/共42页Wouter Meersseman,Fungal infections in COPD. Presented at 4th Trends in Medical Mycology (TIMM), Athens, Grace, Oct.18-21, 2009第13页/共42页牛颖梅,童朝晖.慢性阻塞性肺疾病合并侵袭性肺曲霉病的研究进展.中华结核和呼吸杂志2009年4月第32卷第4期295-297第14页/共42页第15页/共42页第16页/共42页第17页/共4

3、2页第18页/共42页第19页/共42页CTCT提示两上肺实变渗出提示两上肺实变渗出尸检提示两上肺肺实质坏死尸检提示两上肺肺实质坏死 和曲菌菌丝侵犯和曲菌菌丝侵犯第20页/共42页第21页/共42页第22页/共42页P.Bulpa,A.Dive and Y.Sibille. Invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease. Eur Respir J 2007;30:782-800第23页/共42页Wouter Meersseman, Katrien Lagrou, J

4、ohan Maertens,et al., Galactomannan in Bronchoalveolar Lavage Fluid-A Tool for Diagnosing Aspergillosis in Intensive Care Unit Patients. Am J Respir Crit Care Med Vol 177. pp 27-34, 2008第24页/共42页Guinea J, Torres-Narbona M, Gijn P, et al., Pulmonary aspergillosis in patients with chronic obstructive

5、pulmonary disease: incidence, risk factors, and outcome. Clin Microbiol Infect 2009;15(Suppl.4):P1747治疗治疗-COPD-COPD合并合并IPAIPA的治疗文献的治疗文献第25页/共42页Guinea J, Torres-Narbona M, Gijn P, et al., Pulmonary aspergillosis in patients with chronic obstructive pulmonary disease: incidence, risk factors, and out

6、come. Clin Microbiol Infect 2009;15(Suppl.4):P1747第26页/共42页Guinea J, Torres-Narbona M, Gijn P, et al., Pulmonary aspergillosis in patients with chronic obstructive pulmonary disease: incidence, risk factors, and outcome. Clin Microbiol Infect 2009;15(Suppl.4):P1747第27页/共42页Guinea J, Torres-Narbona M

7、, Gijn P, et al., Pulmonary aspergillosis in patients with chronic obstructive pulmonary disease: incidence, risk factors, and outcome. Clin Microbiol Infect 2009;15(Suppl.4):P1747第28页/共42页Guinea J, Torres-Narbona M, Gijn P, et al., Pulmonary aspergillosis in patients with chronic obstructive pulmon

8、ary disease: incidence, risk factors, and outcome. Clin Microbiol Infect 2009;15(Suppl.4):P1747第29页/共42页Wouter Meersseman. Fungal infections in COPD. Presented at 4th Trends in Medical Mycology (TIMM), Athens, Grace, Oct.18-21, 2009第30页/共42页Cadranel J, et al. Phase II trial of voriconazole for treat

9、ment of chronic pulmonary aspergillosis. ATS May 200941位慢性肺病患者合并曲霉菌感染患者(气道采样)的基础肺病情况第31页/共42页Cadranel J, et al. Phase II trial of voriconazole for treatment of chronic pulmonary aspergillosis. ATS May 2009第32页/共42页Cadranel J, et al. Phase II trial of voriconazole for treatment of chronic pulmonary a

10、spergillosis. ATS May 2009第33页/共42页Cadranel J, et al. Phase II trial of voriconazole for treatment of chronic pulmonary aspergillosis. ATS May 2009第34页/共42页Vertigo研究：6个月结果Cadranel J, et al. Phase II trial of voriconazole for treatment of chronic pulmonary aspergillosis. ATS May 2009CNPA：慢性坏死性肺曲霉病 CC

11、PA：慢性空洞性肺曲霉病第35页/共42页Juliette Camuset,Hilario Nunes,Marie-Christine Dombret,et al.,Treatment of Chronic Pulmonary Aspergillosis by Voriconazole in Nonimmunocompromised Patients. CHEST131,5 MAY,2007:1435-1441应用伏立康唑治疗CPA合并IPA后可控制患者病情的发展，明显延长患者平均持续治疗时间，患者治疗时间更充裕预后更佳第36页/共42页Florence Ader,Anne-Lise Bien

12、venu,Blandine Rammaert,et al., Review:Management of invasive aspergillosis in patients with COPD: Rational use of voriconazole. International Journal of COPD 2009:4 279-287第37页/共42页Florence Ader,Anne-Lise Bienvenu,Blandine Rammaert,et al., Review:Management of invasive aspergillosis in patients with

13、 COPD: Rational use of voriconazole. International Journal of COPD 2009:4 279-287第38页/共42页Florence Ader,Anne-Lise Bienvenu,Blandine Rammaert,et al., Review:Management of invasive aspergillosis in patients with COPD: Rational use of voriconazole. International Journal of COPD 2009:4 279-287第39页/共42页1.Florence Ader,Anne-Lise Bienvenu,Blandine Rammaert,et al., Review:Management of invasive aspergillosis in patients with COPD: Rational use of voriconazole. International Journal of COPD 2