国际呼吸杂志
國際呼吸雜誌
국제호흡잡지
INTERNATIONAL JOURNAL OF RESPIRATION
2011年
24期
1841-1844
,共4页
慢性嗜酸粒细胞性肺炎%诊断%治疗
慢性嗜痠粒細胞性肺炎%診斷%治療
만성기산립세포성폐염%진단%치료
Chronic eosinophilic pneumonia%Diagnosis%Treatment
目的 总结慢性嗜酸粒细胞性肺炎(CEP)的临床特点,提高诊治水平.方法 回顾性分析1995年1月至2011年1月在北京协和医院住院的10例CEP患者的临床资料.结果 男性5例,女性5例,合并过敏性鼻炎3例,合并支气管哮喘2例,具有过敏史者2例.主要临床表现为发热(8/10)、咳嗽(8/10)、咯痰(7/10)、呼吸困难(7/10)和胸痛(2/10),常伴乏力(4/10)、纳差(3/10)和体质量下降(1/10).主要体征为湿性啰音(5/10)、散在哮鸣音(2/10)、呼吸音粗糙(2/10)和爆裂音(1/10).9例外周血嗜酸粒细胞计数升高,平均为(2.8±2.5)×109/L,嗜酸粒细胞比例平均为26.7％±19.3％.支气管肺泡灌洗液中嗜酸粒细胞比例为15％～60％,平均38.5％±21.3％.主要影像表现为肺浸润影(8/10),斑片实变影(2/10)和磨玻璃影(1/10).1例病情自发缓解,9例接受糖皮质激素治疗.随访中病情复发2例,出现肺间质纤维化1例.结论 CEP起病隐匿,临床表现缺乏特异性,常合并特应质,多数患者外周血和肺泡灌洗液嗜酸粒细胞数明显升高,典型影像学改变为周边和胸膜下分布为主的肺浸润影.
目的 總結慢性嗜痠粒細胞性肺炎(CEP)的臨床特點,提高診治水平.方法 迴顧性分析1995年1月至2011年1月在北京協和醫院住院的10例CEP患者的臨床資料.結果 男性5例,女性5例,閤併過敏性鼻炎3例,閤併支氣管哮喘2例,具有過敏史者2例.主要臨床錶現為髮熱(8/10)、咳嗽(8/10)、咯痰(7/10)、呼吸睏難(7/10)和胸痛(2/10),常伴乏力(4/10)、納差(3/10)和體質量下降(1/10).主要體徵為濕性啰音(5/10)、散在哮鳴音(2/10)、呼吸音粗糙(2/10)和爆裂音(1/10).9例外週血嗜痠粒細胞計數升高,平均為(2.8±2.5)×109/L,嗜痠粒細胞比例平均為26.7％±19.3％.支氣管肺泡灌洗液中嗜痠粒細胞比例為15％～60％,平均38.5％±21.3％.主要影像錶現為肺浸潤影(8/10),斑片實變影(2/10)和磨玻璃影(1/10).1例病情自髮緩解,9例接受糖皮質激素治療.隨訪中病情複髮2例,齣現肺間質纖維化1例.結論 CEP起病隱匿,臨床錶現缺乏特異性,常閤併特應質,多數患者外週血和肺泡灌洗液嗜痠粒細胞數明顯升高,典型影像學改變為週邊和胸膜下分佈為主的肺浸潤影.
목적 총결만성기산립세포성폐염(CEP)적림상특점,제고진치수평.방법 회고성분석1995년1월지2011년1월재북경협화의원주원적10례CEP환자적림상자료.결과 남성5례,녀성5례,합병과민성비염3례,합병지기관효천2례,구유과민사자2례.주요림상표현위발열(8/10)、해수(8/10)、각담(7/10)、호흡곤난(7/10)화흉통(2/10),상반핍력(4/10)、납차(3/10)화체질량하강(1/10).주요체정위습성라음(5/10)、산재효명음(2/10)、호흡음조조(2/10)화폭렬음(1/10).9예외주혈기산립세포계수승고,평균위(2.8±2.5)×109/L,기산립세포비례평균위26.7％±19.3％.지기관폐포관세액중기산립세포비례위15％～60％,평균38.5％±21.3％.주요영상표현위폐침윤영(8/10),반편실변영(2/10)화마파리영(1/10).1례병정자발완해,9례접수당피질격소치료.수방중병정복발2례,출현폐간질섬유화1례.결론 CEP기병은닉,림상표현결핍특이성,상합병특응질,다수환자외주혈화폐포관세액기산립세포수명현승고,전형영상학개변위주변화흉막하분포위주적폐침윤영.
Objective To investigate the clinical characteristics of chronic eosinophilic pneumonia (CEP)and improve the diagnosis and treatment of the disease.Methods We retrospectively analyzed the clinical data of patients hospitalized with CEP in Peking Union Medical College Hospital from January 1995 to January 2011.Results There were five males and five females in this study,three cases had coexisting allergic rhinitis,two had asthma.The clincal manifestations consisted of fevers(8/10),cough (8/10),expectoration(7/10),dyspnea(7/10),and chest pain(2/10).The respiratory signs consisted of rales(5/10),wheezes(2/10),coarse breath sounds(2/10),and inspiratory crackles(1/10).The blood eosinophilia were present in most case(9/10),mean(2.8 ±+2.5)× 109/L.The average percentage of eosinophils was 26.7 ％ ± 19.3 ％.Bronchoalveolar lavage revealed high levels of eosinophils,representing 15％ to 60％ of the total cell count(mean 38.5％± 21.3％).Bilateral alveolar infiltrates(8/10)and consolidation(2/10)on chest imaging were typical characteristic of CEP.Spontaneous remission occurred in one patient,nine patients received glucocorticoid therapy.Two cases relapsed during the follow-up,one case developed pulmonary interstitial fibrosis after eight months.Conclusions CEP is characterized by subacute or chronic respiratory and general symptoms,coexisting atopic diathesis,alveolar and/or blood eosinophilia is present in most cases.Peripheral pulmonary infilitrates with migratory character on chest imaging is feature of CEP.
