CAJ | 학술논문

　　目的比较非特异性间质性肺炎(nonspecific interstitial pneumonia，NSIP)与隐源性机化性肺炎(cryptogenic organizing pneumonia，COP)的临床、肺功能及影像学特征，以提高临床诊治水平。方法回顾性分析本院2007年3月-2012年6月经病理确诊的7例NSIP和12例COP住院患者的临床、肺功能及影像学资料。结果 NSIP和COP均有咳嗽、活动后呼吸困难及咳痰；与NSIP比较，COP发热、乏力和体重下降等全身症状更为明显；NSIP和COP肺功能均表现为限制性通气功能下降及弥散功能下降；与COP比较，NSIP患者的肺总量占预计值百分比(TLC%)、用力肺活量占预计值百分比(FVC%)、第一秒用力呼气容积占预计值百分比(FEV1%)以及一氧化碳弥散量占预计值百分比(DLCO%)显著减低(P＜0.05)。6例NSIP患者胸部CT为双下肺磨玻璃影，而11例COP患者表现为沿胸膜下或支气管血管束分布的肺实变影。结论 NSIP与COP呼吸系统症状无明显差别，后者全身症状明显。NSIP限制性通气功能及弥散功能下降更明显。两者胸部CT表现不同，肺活检有助于明确诊断。
　　목적비교비특이성간질성폐염(nonspecific interstitial pneumonia，NSIP)여은원성궤화성폐염(cryptogenic organizing pneumonia，COP)적림상、폐공능급영상학특정，이제고림상진치수평。방법회고성분석본원2007년3월-2012년6월경병리학진적7례NSIP화12례COP주원환자적림상、폐공능급영상학자료。결과 NSIP화COP균유해수、활동후호흡곤난급해담；여NSIP비교，COP발열、핍력화체중하강등전신증상경위명현；NSIP화COP폐공능균표현위한제성통기공능하강급미산공능하강；여COP비교，NSIP환자적폐총량점예계치백분비(TLC%)、용력폐활량점예계치백분비(FVC%)、제일초용력호기용적점예계치백분비(FEV1%)이급일양화탄미산량점예계치백분비(DLCO%)현저감저(P＜0.05)。6례NSIP환자흉부CT위쌍하폐마파리영，이11례COP환자표현위연흉막하혹지기관혈관속분포적폐실변영。결론 NSIP여COP호흡계통증상무명현차별，후자전신증상명현。NSIP한제성통기공능급미산공능하강경명현。량자흉부CT표현불동，폐활검유조우명학진단。
Objective To improve the clinical diagnosis and treatment of nonspecific interstitial pneumonia(NSIP) and cryptogenic organizing pneumonia(COP) by comparing the clinical and radiological features and the lung function of such patients. Methods The clinical and radiological features and the lung function of 7 biopsy-proved NSIP patients and 12 biopsy-proved COP patients admitted to our hospital from March 2007 to June 2012 were retrospectively analyzed. Results The clinical symptoms of NSIP and COP patients were manifested as cough, dyspnea and expectoration. The systemic symptoms such as fever, acratia and weight loss were severer in COP patients than in NSIP patients. The lung function was manifested as reduced restrictive ventilation function and diffusion function both in NSIP patients and in COP patients. The TLC%, FVC%, FEV1%and DLCO%were significantly lower in COP patients than in NSIP patients(P<0.05). The chest CT scanning showed ground-glass shadows in both lower lungs of 6 NSIP patients and consolidated shadows in subpleural or perilobular branches of 11 COP patients. Conclusion No significant symptoms can be found in the respiratory system of COP and NSIP patients. However, the systemic symptoms are severer in COP patients than in NSIP patients. CT scanning shows that the restrictive ventilation function and diffusion function are significantly lower in NSIP patients than in COP patients. Lung biopsy contributes to the diagnosis of NSIP and COP.