大环内酯类药物治疗隐源性机化性肺炎一例并文献复习  

Macrolides for the Treatment of COP: A Case Report and Review of the Literature

作　　者：丁群力[1] 吕丹[1] 王碧炯[1] 张巧丽[1] 虞亦鸣[1] 邓在春[1] 

机构地区：[1]宁波大学医学院附属医院呼吸内科,浙江省宁波市315020

出　　处：《中国全科医学》2014年第32期3868-3871,3874,共5页Chinese General Practice

基　　金：宁波大学科研基金资助项目(XYY110003)

摘　　要：目的提高对大环内酯类药物治疗隐源性机化性肺炎(COP)的认识。方法报道1例使用阿奇霉素治疗COP病例的诊治经过,并进行文献复习。对万方数据库和PubMed数据库进行检索,检索时间截至2012年12月,共8篇文献入选,大环内酯类药物治疗COP患者34例。对此34例及本例患者的临床资料以及大环内酯类药物的治疗反应进行总结。结果 35例患者中20例初始即单独应用大环内酯类药物治疗,16例治愈,但病情改善时间较激素明显延长,4例治疗失败;9例联合使用大环内酯类药物治疗后病情改善;6例未评估临床疗效。大环内酯类药物不良反应少见,仅1例患者在使用克拉霉素过程中出现皮疹而停药。结论对轻症COP患者大环内酯类药物可尝试作为一线治疗药物,对在激素减量过程中或停用后反复发作患者加用大环内酯类药物可增强疗效。Objective To improve the understanding of Macrolides for the treatment of cryptogenic organizing pneumonia（ COP）. Methods The treatment and diagnosis of a case of COP with Azithromycin was reported with literature review.Wanfang and PubMed database were searched up to October 2012. Finally 8 literatures were screened including 34 cases of COP patients treated with Macrolides. The clinical data and the patients＇ therapeutic response to Macrolides of 34 cases and the case in this study were summarized. Results 20 out of 35 were treated with sole Macrolides from the beginning,among which 16 cases recovered,but the improving time was obviously longer than with hormone,4 cases failed; 9 out of 35 received combined Macrolides and all improved; 6 out of 35 had no assessment of clinical efficacy. Less side effects of Macrolides was found except one case who appeared skin rash in the middle of clarithromycin treatment and stopped drug later. Conclusion Macrolides might be recommended as the first line therapy for mild COP. For patients who are in the process of hormone reduction or appear repeated recurrence after drug stop,application of Macrolides can enhance the therapeutic effects.

关 键 词：大环内酯类 隐源性机化性肺炎 文献复习 

分 类 号：R563.1[医药卫生—呼吸系统]