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-  2018 

33 例隐源性机化性肺炎临床分析及诊治思考

DOI: doi:10.7507/1671-6205.201711011

Keywords: 隐源性机化性肺炎, 肺组织活检术, 高分辨率 CT

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Abstract:

目的提高临床医生对隐源性机化性肺炎(COP)的认识及诊治水平。 方法收集 2013 年 1 月 1 日至 2016 年 12 月 31 日 4 年期间在南京鼓楼医院住院、经病理确诊为 COP 患者的临床资料,回顾性分析其临床表现、实验室检查及影像学资料。 结果符合纳入标准的 33 例患者中男 18 例,女 15 例,平均年龄(58.7±13.5)岁。患者多亚急性起病,最常见症状为咳嗽、发热、及不同程度的胸闷、呼吸困难等,约半数患者肺部可闻及吸气性爆裂音或捻发音。自身抗体及抗中性粒细胞胞浆抗体均为阴性。胸部高分辨率 CT 表现为肺内多发斑片状密度增高影或实变影,病变以两肺外周及胸膜下分布为主,多沿支气管血管束分布(28/33),少数为局灶结节影(5/33),可伴有肺门或纵隔淋巴结肿大(6/33)、胸腔积液等(2/33)等。25 例患者接受糖皮质激素治疗,6 例接受大环内酯类药物治疗,2 例未予药物治疗,以随访观察为主。 结论临床表现、辅助检查及影像学特征是诊断 COP 的重要线索,确诊还需病理学依据,同时需要排除明确的致病原和潜在的基础疾病

References

[1]  1. American Thoracic Society, European Respiratory Society. American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This Joint Statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. AmJ Respir Crit Care Med, 2002, 165(2): 277-304.
[2]  2. Epler GR. Bronchiolitis obliterans organizing pneumonia. Arch Intern Med, 2001, 161(2): 158-164.
[3]  4. Cordier JF. Cryptogenic organizing pneumonia. Clin Chest Med, 2004, 25(4): 727-738.
[4]  5. 蔡后荣, 李惠萍. 实用间质性肺疾病. 北京: 人民卫生出版社, 2010, 98-111.
[5]  6. 蔡后荣, 侯杰. 隐源性机化性肺炎的临床、病理和影像学诊断. 中国医学影像技术, 2005, 21(7): 1133-1136.
[6]  7. 施举红, 许文兵, 刘鸿瑞, 等. 隐源性机化性肺炎 18 例的临床病理特征. 中华肺结核和呼吸杂志, 2006, 29(3): 167-170.
[7]  8. Schlesinger C, Koss MN. The organizing pneumonia: an update and review. Curr Opin Pulm Med, 2005, 11(5): 422-430.
[8]  9. Bradley B, Branley HM, Egan JJ, et al. Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax, 2008, 63(Suppl 5): v1-v58.
[9]  10. Pathak V, Kuhn JM, Durham C, et al. Macrolide use leads to clinical and radiological improvement in patients with cryptogenic organizing pneumonia. Ann Am Thorac Soc, 2014, 11(1): 87-91.
[10]  11. Shitenberg D, Fruchter O, Fridel L, Kramer MR. Successful rituximab therapy in steroid-resistant, cryptogenic organizing pneumonia: a case series. Respiration, 2015, 90(2): 155-159.
[11]  3. Epler GR, Colby TV, Mc Loud TC, et al. Bronchiolitis obliterans organizing pneumonia. N Engl J Med, 1985, 312(3): 152-158.
[12]  12. Oymak FS, Demirbas HM, Mavili E, et al. Bronchiolitis obliterans organizing pneumonia. Clinical and roentgeuological features in 26 cases. Respiration, 2005, 72(3): 254-262.

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