就典型病例探讨特发性肺含铁血黄素沉着症之诊断及治疗  

A study of diagnosis and treatment of idiopathic pulmonary hemosiderosis from the typical cases

作　　者：王徽信[1] 

机构地区：[1]江西省儿童医院,南昌330006

出　　处：《江西医药》2000年第1期18-20,共3页Jiangxi Medical Journal

摘　　要：目的　讨论IPH的诊断与治疗 ,以提高对本病的认识。方法　利用典型病例 ,参阅各地资料报导 ,总结对本病误诊的原因。结果与结论　通过分析提出误诊率高的三方面的原因 ,并提出降低误诊率首先要提高医师对本病的认识及警惕 ,抓住 4点诊断关键 :(1)反复发热、咳嗽、气促、面色苍白或苍白加重 ;(2 )小细胞低色素性贫血 ,但缺铁的生化检查并不一致 ;(3 )连续追踪检查x线胸片 ,可见毛玻璃状、点片状、网状、纤维状等肺间质性改变 ,而肺部无体征 ;(4)反复查痰及胃液可找到含铁血黄素细胞。同时应注意与IDA、溶贫、肺炎、结核、支扩、先心、心肌炎、肝炎、消化道出血等鉴别 ,排除继发性肺含铁血黄素沉着症。治疗方法有 :肾上腺皮质激素、铁鳌合剂、中医中药必要时输血及其它对症处理。早期治疗预后较好。Objective To deepen the understanding of idopathic pulmonary hemosiderosis(IPH).Methods Two typical cases of our clinic were reviewed and compared with the references.Results and Conclusion For correct diagnosis,attention may pay to lower characteristic:1.Relepsing fever,cough,dyspnea accompanied with severpale;2.anemia with microspherocytes and hypochromatic cells,but hypoferric anemia could be eacluded;3.Serial chest X ray films showed interstitial tissue infiltration;4.Hemosiderin cells from wrine and gastric juice.5.Other systemic,congenital and blood diseases should be excluded.The available treatment of IPH include:cortico steroid used for a relatively long period (several m-years);Dosferaxamine (removed Fe +++ from tissues);Traditional chinese medicine.Whe the treatment take place early,the prognosis will be better.

关 键 词：肺铁血沉着病 IPH 诊断 治疗 

分 类 号：R563.7[医药卫生—呼吸系统]