特发性急性嗜酸粒细胞性肺炎一例临床特征分析  

Analysis of clinical features of a case with idiopathic acute eosinophilic pneumonia

作　　者：宗晓福[1] 汪凤凤[3] 苗伟伟[3] 孙向东 王继旺[3] 周林福[3] 

机构地区：[1]解放军第81医院呼吸科,南京210002 [2]放疗科 [3]南京医科大学第一附属医院呼吸科,210029

出　　处：《国际呼吸杂志》2012年第19期1454-1456,F0003,共4页International Journal of Respiration

基　　金：国家自然科学基金（81170018）;江苏省医学重点人才项目（RC2011066）;江苏省333高层次人才培养工程（201115）;江苏省高校自然科学研究项目（1IK]B320008）;江苏省卫生国际交流支撑计划（201235）

摘　　要：目的探讨特发性急性嗜酸粒细胞性肺炎（IAEP）患者的临床特征。方法分析解放军第81医院收治的1例IAEP患者的临床表现、影像学和病理特点，并综述有关IAEP的文献报道。结果患者为70岁女性，咳嗽、胸闷、间断发热，急性病程，严重低氧血症。胸部CT示游走性肺浸润影伴少量胸腔积液。诊断性胸腔穿刺示胸水嗜酸粒细胞占28％。支气管肺泡灌洗液嗜酸粒细胞占59％。胸部CT引导下经皮肺穿刺活检示嗜酸粒细胞肺浸润。结论IAEP是一种少见病，易被误诊为重症肺炎、急性肺损伤或急性呼吸窘迫综合征，对糖皮质激素敏感，治愈后无复发，预后良好。Objective To explore the clinical features of idiopathic acute eosinophilic pneumonia （IAEP）. Methods The clinical manifestation, radiology, and pathology were analyzed in one patient with IAEP in the 81st Hospital of Chinese PLA following review of the literatures. Results The patient was a 70-year-old female presented with acute cough, chest tightness, intermittent fever, and severe hypoximia. Her chest CT showed migratory lung infiltrate with a small amount of pleural effusion. The diagnostic thoracentesis and bronchial alveolar lavage revealled 28 M and 59 % of eosinophils, respectively. CT-guided lung biopsy demonstrated an eosinophilie pneumonia. Conclusions As a rare disorder, IAEP is often misdiagnosed as severe pneumonia, acute lung injury, and acute respiratory distress syndrome, which is curable to glucocorticoids and has a good prognosis without recurrence.

关 键 词：特发性急性嗜酸粒细胞性肺炎 重症肺炎 支气管哮喘 急性肺损伤 糖皮质激素 

分 类 号：R563.1[医药卫生—呼吸系统]