摘要
目的分析医院40例机化性肺炎(OP)的临床特点,提高对隐源性机化性肺炎(COP)和继发性机化性肺炎(SOP)的诊治认识。方法收集40例OP患者,其中COP组23例,SOP组17例,分析患者临床症状、实验室检查、影像学特点、病理检查、治疗疗效的临床资料,进行比较总结分析。结果COP组与SOP组临床表现、影像学检查、组织病理无特异性,比较差异无统计学意义;两组C-反应蛋白(CRP)比较差异有统计学意义(P<0.05);肺部影像学边界不清斑片实变影两组有统计学意义(P<0.05);激素是治疗OP的主要方式,COP与SOP激素治疗上无明显差异,SOP治疗需同时治疗基础疾病。结论COP与SOP临床表现、实验室检查差异性小,影像学及组织病理学一定程度上可以鉴别,治疗均以糖皮质激素为主,大环内酯类药物也可以作为替代治疗,SOP需同时治疗原发疾病,手术治疗有一定参考价值。
OBJECTIVE To analyze the clinical characteristics of 40 patients with organized pneumonia(OP)in our hospital,and to improve the diagnosis and treatment of cryptogenic organized pneumonia(COP)and secandary organized pneumonia(SOP).METHODS Total of 40 patients with OP were recruited in the study,including 23 cases in the COP group and 17 cases in the SOP group.Clinical data of clinical symptoms,laboratory examination,imaging characteristics,pathological examination and therapeutic effect were analyzed and compared between the two groups.RESULTS There was no difference in clinical manifestations,imaging examination and histopathology between the COP group and SOP group.C-reactive protein(CRP)level increased in both groups,and the difference was significant(P<0.05).The difference in consolidation of well-defined pulmonary plaques on imaging between the two groups was significant different(P<0.05).The difference in glucocorticoids,which is the main way to treat OP between the COP and SOP group was not significant.Patients with SOP needs to be treated with underlying diseases at the same time.CONCLUSION The difference in clinical manifestations and laboratory examination between COP and SOP is small,but imaging and histopathology assays can distinguish them to a certain extent.Glucocorticoids are the main drug in the treatment,and macrolides can also be used as an alternative treatment.Primary disease in SOP patients should be treated the at the same time,and surgical treatment may be considered.
作者
苏鑫
顾恒琼
李玉柱
SU Xin;GU Heng-qiong;LI Yu-zhu(Hainan Hospital of PLA Ceneral Hospital,Sanya,Hainan 572013,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2021年第24期3727-3731,共5页
Chinese Journal of Nosocomiology
关键词
机化性肺炎
隐源性机化性肺炎
继发性机化性肺炎
临床特征
病理
治疗
Organized pneumonia
Cryptogenic organized pneumonia
Secondary organized pneumonia
Clinical features
Pathology
Treatment
