咳嗽伴呼吸困难2个月  

Cryptogenic organising pneumonia： case report and literature review

作　　者：李裕军[1] 赵子文[1] 

机构地区：[1]广州医学院附属广州市第一人民医院呼吸内科,510180

出　　处：《国际呼吸杂志》2012年第11期854-858,共5页International Journal of Respiration

摘　　要：目的通过病例讨论的方式提高对隐原性机化性肺炎（cryptogenie organising pneumonia，COP）的认识。方法结合我院收治的一例COP病例的临床资料、病例讨论发言记录及对相关文献进行分析。结果患者女，66岁，表现为干咳及进行性加重的活动后呼吸困难，胸部CT示两肺多发病灶（两下肺明显），位于胸膜下，磨玻璃样改变，部分实变。反复细菌培养未发现致病菌，自身抗体、血管炎、免疫球蛋白系列，补体C3及C4、类风湿因子均未见异常，结合病理结果及临床排除其他明确的致病原（如感染）或其他伴随疾病（如结缔组织疾病）后，诊断COP，经激素治疗后恢复良好。结论COP的临床表现不典型，容易误诊，需结合临床、影像学特征及病理表现，除外已知因素后作出诊断，是一个综合判断的过程。Objective To study the clinical characteristics of cryptogenic organising pneumonia （COP）. Methods A case of COP was analyzed and the related literature was reviewed. Results A 66 year-old female patient presented with dry cough and progressive dyspnea was admitted to this hospital. Chest CT scan showed ground-glass opacification and consolidation distributed along the subpleural lungs. The lower lung zones were more predominance. Histological examination of the biopsy specimens obtained under CT guidance showed that the lung alveoli were filled with loose plugs of granulation tissue. Secondary reaction to infections, connective tissue diseases, malignancies and drugs were exclude. The diagnosis of COP was confirmed and patient recover quickly on administration of oral corticosteroids. Conclusions COP is diagnosed in the appropriate clinical, radiographic, and pathologic setting after excluding diseases associated with secondary organising pneumonia.

关 键 词：隐原性机化性肺炎 临床特点 

分 类 号：R563.1[医药卫生—呼吸系统]