中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2015年
9期
669-674
,共6页
沈威%李慧%代静泓%苗立云%肖永龙%曹敏%黄妹%曹孟淑%孟凡青
瀋威%李慧%代靜泓%苗立雲%肖永龍%曹敏%黃妹%曹孟淑%孟凡青
침위%리혜%대정홍%묘립운%초영룡%조민%황매%조맹숙%맹범청
隐源性机化性肺炎%结缔组织病相关性机化性肺炎%临床表现%高分辨率CT
隱源性機化性肺炎%結締組織病相關性機化性肺炎%臨床錶現%高分辨率CT
은원성궤화성폐염%결체조직병상관성궤화성폐염%림상표현%고분변솔CT
Cryptogenic organizing pneumonia%Connective tissue disease,organizing pneumonia%Clinical features%High-resolution CT
目的 探讨隐源性机化性肺炎(COP)和结缔组织病相关性机化性肺炎(CTD-OP)的临床表现和影像学特点.方法 回顾性分析南京鼓楼医院2005-2013年52例经病理证实的机化性肺炎资料,其中男24例,女28例,平均年龄(55±11)岁,30例为COP,22例为CTD-OP.结果 CTD-OP的原发病多为干燥综合征、皮肌炎/多发性肌炎、类风湿关节炎,两组患者在咳嗽、咳痰、咯血、呼吸困难、发热及胸痛等临床表现方面无明显差别,CTD-OP组女性患者比例(17/22)明显高于COP组(11/30,P＜0.01),两组肺功能损害均以限制性通气功能障碍为主,组间比较差异无统计学意义(P＞0.05);两组ANA阳性率有明显差异(CTD-OP组14/22,COP组3/30,P＜0.01);两组影像学改变无明显差异,均以斑片状实变影、条索状影及磨玻璃影最常见,部分患者表现为孤立性块状影,少量患者伴有胸腔积液;网格样改变少见;分布均以两肺胸膜下最常见,可沿支气管血管束分布.结论 COP和CTD-OP患者的呼吸道症状和影像学表现无明显差异,CTD-OP组中女性患者比例、ANA阳性率、关节痛及皮疹等肺外症状明显高于COP组.
目的 探討隱源性機化性肺炎(COP)和結締組織病相關性機化性肺炎(CTD-OP)的臨床錶現和影像學特點.方法 迴顧性分析南京鼓樓醫院2005-2013年52例經病理證實的機化性肺炎資料,其中男24例,女28例,平均年齡(55±11)歲,30例為COP,22例為CTD-OP.結果 CTD-OP的原髮病多為榦燥綜閤徵、皮肌炎/多髮性肌炎、類風濕關節炎,兩組患者在咳嗽、咳痰、咯血、呼吸睏難、髮熱及胸痛等臨床錶現方麵無明顯差彆,CTD-OP組女性患者比例(17/22)明顯高于COP組(11/30,P＜0.01),兩組肺功能損害均以限製性通氣功能障礙為主,組間比較差異無統計學意義(P＞0.05);兩組ANA暘性率有明顯差異(CTD-OP組14/22,COP組3/30,P＜0.01);兩組影像學改變無明顯差異,均以斑片狀實變影、條索狀影及磨玻璃影最常見,部分患者錶現為孤立性塊狀影,少量患者伴有胸腔積液;網格樣改變少見;分佈均以兩肺胸膜下最常見,可沿支氣管血管束分佈.結論 COP和CTD-OP患者的呼吸道癥狀和影像學錶現無明顯差異,CTD-OP組中女性患者比例、ANA暘性率、關節痛及皮疹等肺外癥狀明顯高于COP組.
목적 탐토은원성궤화성폐염(COP)화결체조직병상관성궤화성폐염(CTD-OP)적림상표현화영상학특점.방법 회고성분석남경고루의원2005-2013년52례경병리증실적궤화성폐염자료,기중남24례,녀28례,평균년령(55±11)세,30례위COP,22례위CTD-OP.결과 CTD-OP적원발병다위간조종합정、피기염/다발성기염、류풍습관절염,량조환자재해수、해담、각혈、호흡곤난、발열급흉통등림상표현방면무명현차별,CTD-OP조녀성환자비례(17/22)명현고우COP조(11/30,P＜0.01),량조폐공능손해균이한제성통기공능장애위주,조간비교차이무통계학의의(P＞0.05);량조ANA양성솔유명현차이(CTD-OP조14/22,COP조3/30,P＜0.01);량조영상학개변무명현차이,균이반편상실변영、조색상영급마파리영최상견,부분환자표현위고립성괴상영,소량환자반유흉강적액;망격양개변소견;분포균이량폐흉막하최상견,가연지기관혈관속분포.결론 COP화CTD-OP환자적호흡도증상화영상학표현무명현차이,CTD-OP조중녀성환자비례、ANA양성솔、관절통급피진등폐외증상명현고우COP조.
Objective To investigate the difference in clinical features and radiologic findings between patients with cryptogenic organizing pneumonia (COP) and connective tissue disorder related organizing pneumonia (CTD-OP).Methods A total of 30 subjects with COP and 22 subjects with CTD-OP collected from 2005 to 2013 were retrospectively reviewed in the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School,and the diagnosis of all patients were confirmed by lung biopsy.Results The common underlying diseases in patients with CTD-OP were Sjogren syndrome (SS),poly-/ dermatomyositis(PM/DM),rheumatoid arthritis (RA).There were no significant differences in clinical manifestations between CTD-OP and COP.Compared with COP patients,the proportion of female patients was higher in CTD-OP.Higher positive rate for ANA was found in CTD-OP group(CTD-OP:63.6％;COP:10.0％;P ＜0.01).There were no significant differences in parameters of lung function between CTD-OP and COP.As to radiological findings,the most common patterns were multiple patchy,linear shadows and ground-glass opacity.Some patients showed solitary nodule or consolidation and pleural effusion.Reticular shadow was a rare pattern among these patients.Most lesions were under the pleura and/or around the bronchus.Conclusions There are no significant differences in clinical and radiologic manifestations between COP and CTD-OP,except that the proportion of women and ANA positive rate were higher in CTD-OP.
