摘要
目的探讨隐原性机化性肺炎（cryptogenic organizing pneumonia，COP）的临床特点以及治疗方法，以提高对本病的认识。方法回顾性地总结分析2003年8月～2006年1月在我院呼吸科住院的6例COP患者的临床、影像、实验室检查特点以及对糖皮质激素的治疗反应。结果6例COP患者多表现为咳嗽、呼吸困难、发热；肺部听诊可闻及Velcro啰音；胸部CT可见磨玻璃影、实变影、弥漫性浸润影、空洞及胸腔渗出影；外周血白细胞总数增多、血沉和C-反应蛋白升高、肺功能呈限制性和弥散功能障碍；这些病例均经过肺穿刺活检或TBLB病理证实。其中5例患者在给予甲泼尼龙40mg治疗，病情好转后逐渐减量维持1年，控制良好。结论COP病情呈进行性加重，临床表现类似细菌性肺炎，诊断比较困难，提高对本病的认识是正确诊断的关键，糖皮质激素治疗有特效。
Objective The purpose of this study was to describe the clinical and CT features in Cryptogenic organizing pneumonia （COP）, and method of managemant. Methods We reviewed characteristics of clinical, laboratory, chest CT and pulmonary function test of 6 patients with histologically proven COP, and evaluated their therapeutic response to corticosteroids. Results Most patients of 6 cases manifested as a persistent nonproductive cough, exerting dyspnea, pyrexia, malaise, and weight loss clinically. Less common symptoms include pleuritic chest pain and hemoptysis. Chest CT manifestations included ground - glass opacity, consolidation, diffusing reticular infiltration of parenchyma, pleural effusion, cavitation and migration. The patients had high level of peripheral WBC number, erythrocyte sedimentation, and C - reactive protein. Pulmonary function tests showed a impairment of restrictive pattern and diffusion capacity. All but one Patients responsed well to corticosteroids. Conclusions COP is a rapidly developing pneumonia - like illness characterized by lung inflammation, The clinical doctor must always be aware of the full view of COP so as to achieve successful diagnosis. Most of the patient can recover with corticosteroids therapy.
出处
《医学研究杂志》
2007年第11期84-86,共3页
Journal of Medical Research
关键词
隐原性机化性肺炎
诊断
治疗
Cryptogenic organizing pneumonia
Diagnosis
Treatment
