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HIV感染者的气胸

Author
Patricia A Tietjen, MD
Section Editors
John G Bartlett, MD
V Courtney Broaddus, MD
Deputy Editor
Geraldine Finlay, MD
Translators
戴纪刚, 主任医师，教授

引言

在人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染中，气胸是一种不常见但可能致命的并发症[1-6]。一项前瞻性观察性研究纳入了一队599例随访超过3年的HIV感染者，在所有住院病例中有1.2%并发了气胸[1]。该报告显示，发生气胸与院内死亡率显著增加相关(31% vs 无气胸患者院内死亡率为6%)。

HIV感染者发生气胸的原因包括：耶氏肺孢子菌(Pneumocystis jirovecii)肺炎(Pneumocystis jirovecii pneumonia, PCP)[3,4,6-17]、医源性气胸[18]、Kaposi肉瘤[19]、静脉注射毒品[20]、弓形虫病[7]，以及细菌、真菌、病毒和分枝杆菌感染[1-4,21-23]。

本专题将概述HIV感染者的气胸。原发性和继发性自发性气胸的病因及治疗的总结参见其他专题。 (参见“成人原发性自发性气胸”和“成人继发性自发性气胸”)

发病机制

虽然尚不明确PCP患者发生气胸的原因，但主要的假设集中于耶氏肺孢子菌引发的组织坏死，以及使用喷他脒喷雾进行预防治疗的可能影响。

耶氏肺孢子菌 — 一些研究者认为，肺泡间质组织内广泛的组织浸润在重度PCP患者中常见，是造成组织坏死和之后发生气胸的一个重要因素[24-28]。以下观察结果可以阐明这一点：

           

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Literature review current through: 2017-06 . | This topic last updated: 2017-07-11.
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