隐源性机化性肺炎误诊社区获得性肺炎24例并文献复习  

Cryptogenic organizing pneumonia misdiagnosed as community acquired pneumonia

作　　者：郭海英[1] 包婺平[1] 周新[1] 

机构地区：[1]上海交通大学附属第一人民医院呼吸科,上海200080

出　　处：《诊断学理论与实践》2013年第2期166-169,共4页Journal of Diagnostics Concepts & Practice

摘　　要：目的:回顾分析24例被误诊为社区获得性肺炎的隐源性机化性肺炎(COP)患者的临床资料,以提高对该病的认识。方法:回顾分析24例拟诊为"社区获得性肺炎"患者的临床表现、实验室和辅助检查结果。结果:24例"社区获得性肺炎"患者抗菌治疗均无效,其中2例行支气管镜肺活检,21例行经皮肺穿刺活检,1例经外科胸腔镜手术病理检查,最终均确诊为COP。所有患者接受糖皮质激素治疗后均有效。结论:COP患者的临床表现及影像学表现缺乏特异性,易被误诊为社区获得性肺炎等疾病。经支气管镜肺活检及经皮肺穿刺活检是确诊COP的重要手段。抗菌药物对COP治疗无效,而糖皮质激素治疗该病有效。Objective To analyze the clinical data of 24 cases of cryptogenic organizing pneumonia misdiagnosed as community acquired pneumonia for improving the awareness of this disease in clinical practice. Methods Clinical manifestation, experimental and auxiliary examination data of the 24 misdiagnosed as community acquired pneumonia patients were analyzed retrospectively. Results No patient had response to antibacterial drugs. They were diagnosed as cryptogenic organizing pneumonia by lung biopsy. Bronchoscopic lung biopsy was performed in 2 cases, percutaneous lung biopsy was performed in 21 cases and video-assisted thoracoscopic lung biopsy was performed in 1 case. All of them were treated with corticosteroids with effective responses. Conclusions Because of the nonspeeific clinical and radiographic manifestations, cryptogenic organizing pneumonia might be misdiagnosed as pneumonia or other diseases. Bronchoscopie lung biopsy and percutaneous lung biopsy appear to be the important approach for diagnosing cryptogenic organizing pneumonia. Corticosteroids therapy is effective for this disease.

关 键 词：隐源性机化性肺炎 误诊 社区获得性肺炎 

分 类 号：R563.13[医药卫生—呼吸系统]