CAJ | 학술논문

目的：提高对大环内酯类药物治疗隐源性机化性肺炎（COP）的认识。方法报道1例使用阿奇霉素治疗 COP 病例的诊治经过，并进行文献复习。对万方数据库和 PubMed 数据库进行检索，检索时间截至2012年12月，共8篇文献入选，大环内酯类药物治疗 COP 患者34例。对此34例及本例患者的临床资料以及大环内酯类药物的治疗反应进行总结。结果35例患者中20例初始即单独应用大环内酯类药物治疗，16例治愈，但病情改善时间较激素明显延长，4例治疗失败；9例联合使用大环内酯类药物治疗后病情改善；6例未评估临床疗效。大环内酯类药物不良反应少见，仅1例患者在使用克拉霉素过程中出现皮疹而停药。结论对轻症 COP 患者大环内酯类药物可尝试作为一线治疗药物，对在激素减量过程中或停用后反复发作患者加用大环内酯类药物可增强疗效。
목적：제고대대배내지류약물치료은원성궤화성폐염（COP）적인식。방법보도1례사용아기매소치료 COP 병례적진치경과，병진행문헌복습。대만방수거고화 PubMed 수거고진행검색，검색시간절지2012년12월，공8편문헌입선，대배내지류약물치료 COP 환자34례。대차34례급본례환자적림상자료이급대배내지류약물적치료반응진행총결。결과35례환자중20례초시즉단독응용대배내지류약물치료，16례치유，단병정개선시간교격소명현연장，4례치료실패；9례연합사용대배내지류약물치료후병정개선；6례미평고림상료효。대배내지류약물불량반응소견，부1례환자재사용극랍매소과정중출현피진이정약。결론대경증 COP 환자대배내지류약물가상시작위일선치료약물，대재격소감량과정중혹정용후반복발작환자가용대배내지류약물가증강료효。
Objective To improve the understanding of Macrolides for the treatment of cryptogenic organizing pneumo-nia(COP). Methods The treatment and diagnosis of a case of COP with Azithromycin was reported with literature review. Wanfang and PubMed database were searched up to October 2012. Finally 8 literatures were screened including 34 cases of COP patients treated with Macrolides. The clinical data and the patients' therapeutic response to Macrolides of 34 cases and the case in this study were summarized. Results 20 out of 35 were treated with sole Macrolides from the beginning,among which 16 cases recovered,but the improving time was obviously longer than with hormone,4 cases failed;9 out of 35 received combined Mac-rolides and all improved;6 out of 35 had no assessment of clinical efficacy. Less side effects of Macrolides was found except one case who appeared skin rash in the middle of clarithromycin treatment and stopped drug later. Conclusion Macrolides might be recommended as the first line therapy for mild COP. For patients who are in the process of hormone reduction or appear repeated recurrence after drug stop,application of Macrolides can enhance the therapeutic effects.