Аннотация
Клиническое значение Pneumocystis carinii как возбудителя пневмонии установлено в 1942 г. До недавнего времени большинство специалистов относило P.carinii к простейшим. Однако сейчас имеются бесспорные доказательства принадлежности этого микроорганизма к грибам. До появления иммуносупрессивной терапии и СПИДа пневмоцистная пневмония была редким заболеванием, отмечавшимся преимущественно у недоношенных новорожденных. Основным звеном в развитии пневмоцистной пневмонии является нарушение числа и/или функции Т-лимфоцитов. Однако состояние гуморального иммунитета, по видимому, также играет определенную роль. Для диагностики пневмоцистной пневмонии необходима визуализация микроорганизма в клиническом материале. Основной метод диагностики – бронхоальвеолярный лаваж. Используются также индуцированное отделение мокроты, трахеальная аспирация, трансбронхиальная биопсия, открытая биопсия легких. Препаратом выбора как для терапии, так и для профилактики пневмоцистной пневмонии с 1975 г. является ко тримоксазол. Активностью против P.carinii обладают также пентамидин, атоваквон, триметрексат, дапсон и др. Ведется разработка новых антипневмоцистных препаратов, таких, как пневмокандины, бенаномицины, сордарины, селективные ингибиторы дигидрофолатредуктазы.
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