中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2011年
8期
822-826
,共5页
克罗恩病%肺疾病%柳氮磺胺吡啶
剋囉恩病%肺疾病%柳氮磺胺吡啶
극라은병%폐질병%류담광알필정
Crohn disease%Lung disease%Salicylazosulfapyridine
目的 探讨累及肺脏克罗恩病的临床表现.方法 对我院收治1例临床确诊累及肺脏克罗恩病患者的临床资料进行分析,并结合文献进行复习.结果 患者临床表现为咳嗽、咳痰、发热,胸部CT示双肺斑片状阴影,病原学检查阴性,抗菌治疗2个月双肺阴影无明显变化,纤维支气管镜示气管及右上叶开口处结节状新生物,病理示肉芽组织息肉状增生,给予泼尼松和柳氮磺胺吡啶治疗半个月后双肺阴影明显消散,气管内结节消失,右上叶开口处结节明显缩小.检测到以英文发表的相关文献,病理确诊的克罗恩病累及肺脏或合并肺部并发症病例共34例.克罗恩病累及肺脏罕见,以咳嗽、咳痰、发热为常见临床表现,肺脏和肠道常有相同病变理变化,即肉芽肿性炎症.对糖皮质激素反应良好,可应用糖皮质激素加柳氮磺胺吡啶治疗.结论 克罗恩病出现呼吸道症状时应考虑累及肺脏的可能,结合临床和病理可以确诊.
目的 探討纍及肺髒剋囉恩病的臨床錶現.方法 對我院收治1例臨床確診纍及肺髒剋囉恩病患者的臨床資料進行分析,併結閤文獻進行複習.結果 患者臨床錶現為咳嗽、咳痰、髮熱,胸部CT示雙肺斑片狀陰影,病原學檢查陰性,抗菌治療2箇月雙肺陰影無明顯變化,纖維支氣管鏡示氣管及右上葉開口處結節狀新生物,病理示肉芽組織息肉狀增生,給予潑尼鬆和柳氮磺胺吡啶治療半箇月後雙肺陰影明顯消散,氣管內結節消失,右上葉開口處結節明顯縮小.檢測到以英文髮錶的相關文獻,病理確診的剋囉恩病纍及肺髒或閤併肺部併髮癥病例共34例.剋囉恩病纍及肺髒罕見,以咳嗽、咳痰、髮熱為常見臨床錶現,肺髒和腸道常有相同病變理變化,即肉芽腫性炎癥.對糖皮質激素反應良好,可應用糖皮質激素加柳氮磺胺吡啶治療.結論 剋囉恩病齣現呼吸道癥狀時應攷慮纍及肺髒的可能,結閤臨床和病理可以確診.
목적 탐토루급폐장극라은병적림상표현.방법 대아원수치1례림상학진루급폐장극라은병환자적림상자료진행분석,병결합문헌진행복습.결과 환자림상표현위해수、해담、발열,흉부CT시쌍폐반편상음영,병원학검사음성,항균치료2개월쌍폐음영무명현변화,섬유지기관경시기관급우상협개구처결절상신생물,병리시육아조직식육상증생,급여발니송화류담광알필정치료반개월후쌍폐음영명현소산,기관내결절소실,우상협개구처결절명현축소.검측도이영문발표적상관문헌,병리학진적극라은병루급폐장혹합병폐부병발증병례공34례.극라은병루급폐장한견,이해수、해담、발열위상견림상표현,폐장화장도상유상동병변리변화,즉육아종성염증.대당피질격소반응량호,가응용당피질격소가류담광알필정치료.결론 극라은병출현호흡도증상시응고필루급폐장적가능,결합림상화병리가이학진.
Objective To describe the characteristics of pulmonary involvement in Crohn was described and relevant literature were reviewed. Results The patient showed chief complaints of cough,expectoration and fever. The chest CT scan revealed bilateral lung opacity shadows ,Ziehl-Neelsen acid-fast stain examination in sputum and cultures got negative results for many times. Chest CT scan revealed no dissipation after different antimicrobials treatment for 2 months. The fiberoptic bronchoscopy was performed, which showed nodular lesions in the trachea and beside the opening of right upper lobe. Histopathology showed polypoid hyperplasia of granulation tissue. The bilateral patchy opacity dissipated, the nodes in the trachea disappeared and the nodes beside the opening of right upper lobe diminished obviously after the patient was treated with oral prednisone and salicylazosulfapyridine (SASP). Pulmonary involvement in Crohn disease is very rare and it can involve any part of the lungs. The most common manifestations are cough, expectoration and fever. The lung and gastrointestinal system often share similar pathogenetic changes: granulomatous inflammation. These patients responded well to combination use of glucocorticoid and SASP. Conclusion Pulmonary involvement should be considered when patients with Crohn disease manifested with respiratory symptoms, which can be definitely diagnosed by clinical features and histopathological examintation.
