آسپرژیلوزیس تهاجمی در بیماران مبتلا به COPD؛ از تشخیص تا درمان
فصلنامه نفس,
دوره 1 شماره 1 (1393),
5 June 2014
چکیده
آسپرژیلوزيس تهاجمی (IA)، عفونت شديد و كشنده قارچی با مرگ و مير بسيار بالا در بيماران با ضعف سيستم ايمني، به خصوص در بیماران مبتلا به بدخیمیهای خونی ميباشد. با اين حال این عفونت بصورت قابل توجه و فزايندهاي در افراد داراي سيستم ايمني کامل كه به علت COPD در بخشهاي ICU (به ويژه بیماران COPD تیپ III و IV) بستري شدهاند نیز گزارش شده است.با توجه به شرایط ویژه بیماری COPD، کلونیزاسیون عوامل میکروبی، بخصوص قارچ آسپرژیلوس، در ریه افراد مبتلا به اين بيماري به راحتی ایجاد ميشود. مواردي چون مصرف مداوم آنتیبیوتیکهای وسیعالطیف، نیاز به بستری شدن در بخشهای ICU، استفاده از تجهیزات و روشهای تهاجمی در آنها، و نيز استفاده از داروهای استروئیدی موجب ميگردند تا اين بيماران از گروههای پر خطر در معرض ابتلا عفونتهای فرصت طلب مثل IA باشند. آشنایی با شرایط ابتلا، فرایندهای تشخیص سریع و درمان مناسب از نیازهای مبرم جهت کنترل و جلوگیری از شیوع بالای اين بیماری میباشند. علاوه بر روشهای سنتی، استفاده از تکنیکهای تشخیصی سرولوژی مثل ارزیابی آنتیژنهای گالاکتومانان و بتا 1 و 3 دیگلوکان و همچنین تکنیکهای مولکولی PCR در نمونههاي مختلف، در تشخیص سریع IA این بیماران ضروری میباشند. در مقاله حاضر سعی شده است با مرور تازهترین بررسیهای انجام شده بر روی IA در بیماران مبتلا به COPD، به جنبههای مختلف آن، با تاکید بر روشهای تشخیصی و درمانی جدید پرداخته شود.
- COPD
- كلونيزاسيون
- آسپرژيلوزيس
ارجاع به مقاله
مراجع
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