目的 探讨利奈唑胺治疗耐多药结核病的疗效和安全性.方法 回顾性分析利奈唑胺治疗耐多药结核病致严重贫血病例 1 例,结合文献对利奈唑胺对耐多药结核病的临床疗效,贫血等血液系统不良反应发生情况、防治方法等进行分析.结果 患者因治疗耐药结核病服用利奈唑胺 0.6 g,1 天2 次,用药 58 天后出现严重贫血,血红蛋白 48 g/L.停药,给予输注悬浮红细胞 8U对症支持治疗,血红蛋白升高至 108 g/L,利奈唑胺减量至 0.3 g,1 天 1 次,继续抗结核治疗.随访患者 2 个多月,复查血红蛋白131 g/L,利奈唑胺调整至0.6 g,1 天1 次,继续随访患者2 个多月,患者血红蛋白122 g/L,结核病情控制稳定.结论 耐药结核病需要长疗程使用利奈唑胺,利奈唑胺所致贫血是血液系统常见的严重不良反应,用药过程中应及时监测血常规调整剂量,保障治疗效果的同时保障患者用药安全.

目的:总结重型新型冠状病毒肺炎(COVID-19)患者的临床特征、实验室检查特点及转归,为更好地防治重型COVID-19提供科学依据.方法:整理2020年1月23日～2月22日在弋矶山医院治愈出院的4例重型COVID-19患者的临床资料,对其一般资料、临床体征、实验室检查、治疗措施及转归情况进行分析.结果:患者平均年龄为(52.0±3.92)岁,主要临床症状为发热、干咳、乏力、胸闷及呼吸困难等,4例患者中性粒细胞与淋巴细胞比值(NLR)分别为19.5、11.0、15.0、4.7;CD3+T淋巴细胞(318.75±166.58)×106 g/L、CD3+CD4+T淋巴细胞(189.75±128.77)×106 g/L、CD3+CD8+T淋巴细胞(107.25±43.22)×106 g/L均较正常水平下降,胸部CT表现为双肺外带多发斑片状阴影.4例患者住院期间接受了高流量氧疗(HFNC)、免疫调节、抗病毒等综合治疗后均好转出院.结论:早期识别重症患者,及时有效的呼吸支持、免疫调节等综合治疗有助于降低不良后果的发生.

BackgroundPregnant women due to reduced resistance, the probability of tuberculosis infection increased, easy to lead to the occurrence of tuberculosis, so pregnancy with tuberculosis is a risk to the health of pregnant women infectious diseases. However, the clinical symptoms of pregnancy with pulmonary tuberculosis are atypical, confused with the physiological reactions of pregnancy, and lack of clinical awareness, especially under the influence of the global COVID-19 epidemic, lung atypical lesions are prone to misdiagnosis or delayed diagnosis.Case presentationA 21-year-old woman was infected with Mycobacterium tuberculosis during the third trimester of pregnancy. The diagnosis and treatment of the patient were reported.ConclusionThe interaction between tuberculosis and pregnancy is like a double-edged sword. Reaising doctors’awareness on tuberculosis is fundamental, and early diagnosis and standardized treatment are the key to improve the outcome of pregnancy.

目的:描述分析芜湖市新型冠状病毒肺炎(COVID-19)患者的临床特征及其转归,总结临床治疗方案,并分析COVID-19患者预后的影响因素.方法:收集芜湖市已出院的31例COVID-19患者的临床资料,总结其临床表现、实验室检查结果以及影像学表现,回顾性分析影响患者临床预后的各种可能因素.结果:31例患者的年龄中位数为39(32～54)岁,入院时白细胞减少5例(16.1％),淋巴细胞减少9例(29％),其中29例(93.5％)胸部CT有异常表现,20例(64.5％)为双侧病灶.从发病到住院的中位时间为4(2～6)d,使用糖皮质激素11例(35.5％),三联抗病毒治疗患者5例(16.1％).病毒清除时间14(11.5～16)d,症状持续时间7(5～10.5)d,住院时间18.5(16～21)d.多元线性回归分析显示激素治疗对患者临床预后影响无统计学意义(P>0.05),三联抗病毒治疗可能缩短病毒清除时间(-3.86,95％CI:-7.59,-0.19,P=0.040)及住院时间(-5.57,95％CI:-10.24,-0.90,P=0.022).结论:所有轻症COVID-19患者均预后良好,三联抗病毒治疗可能缩短病毒清除时间及住院时间.

Objective To analyze the imaging manifestation of the pulmonary infarction. Methods The changes of the X-ray, CT and ultrasound imaging of 10 patients with the pulmonary infarction diagnosed by the clinical signs and pathogenesis were analyzed. Results The number of the lesion in 10 patients amounted to 38 in total. The maximum number was 6 in one patient. Bilateral pulmonary infarction occurred in 4 patients and multiple lobes were involved in 3 among the 4 patients. More than two patchy spots in the lateromedial filed of the lung. There was the truncation sign at the base of the right lower pulmonary artery. The outer edge of the lesion was thickened in the pleura. There was a little pleural effusion. The atelectasis was found in the inferior lung. The diaphragm was elevated. There was the manifestation of the acute pulmonary heart disease. Conclusion The lung infarction can be accurately diagnosed in time with the imaging manifestation combined with the clinical examination.