高分辨CT及经支气管镜肺活检、C反应蛋白在弥漫性间质性肺病的临床病理研究  

Clinical and pathological research of HRCT,TBLB and CRP for diffuse interstitial lung disease

作　　者：贾建军[1] 刘瑞娟[1] 王留新[1] 李秀英[1] 

机构地区：[1]山东省济宁市第一人民医院呼吸内科,山东济宁272000

出　　处：《中国内镜杂志》2015年第6期631-635,共5页China Journal of Endoscopy

摘　　要：目的探讨纤维支气管镜肺活检(T BLB)、C-反应蛋白(C R P)与H R C T并结合临床用于诊断弥漫性肺疾病(D LD)的价值。方法回顾性分析该院2003年1月-2013年6月接受支气管镜肺活检(T BLB)并行血C R P监测的257例具有临床和病理诊断资料D LD患者。结果 257例D LD患者中行T BLB确诊138例(53.85%),病理诊断包括其中特发性间质性肺纤维化(IPF)50例,肺泡癌10例,肺结核15例,结节病10例,癌性淋巴管炎10例,肺泡蛋白沉积症5例,过敏性肺泡炎8例,非特异性间质性肺炎(N SIP)5例,结缔组织肺病10例,隐原性机化性肺炎(C O P)12例。特发性间质性肺炎、结缔组织肺病及结核血C R P明显升高。结论T BLB对弥漫性肺疾病有较高的诊断价值,安全性好,创伤小,临床、影像和病理诊断之间的统一和协调对临床难确诊的弥漫性肺疾病有着重要的意义。C R P对一些间质性肺病诊断提供了一定的数据依据。【Objective】To evaluate the diagnostic value of transbronchial lung biopsy（TBLB）, CRP and HRCT on diffuse lung disease（DLD）. 【Methods】TBLB was performed in 257 patients with defuse lung diseases from January 2003 to June 2013 in Jining No.1 People Hospital. The levels of CRP from the patients were monitored. The results of clinical data and pathologic diagnosis were retrospectively analyzed. 【Results】Confirmed diagnosis by TBLB was obtained in 138 patients, the total positive diagnostic rate was 53.8%. The diseases included idiopathic pulmonary fibrosispulmonary（IPF）（50/138）, alveolar cell carcinoma（10/138） sarcoidosis（10/138）, lymphangitis carcinomatosa（10/138）, pulmonary tuberculosis（15/138）, pulmonary alveolar proteinosis（5/138）, sequoiosis（8/138）nonspecific interstitial pneumonia（5/138）, bronchiolitiso bliterans organizing pneumonia/organizing pneumonia（BOOP/OP）（12/138）, and connective tissue lung disease（10/138）. The level of CRP is high for IPF, pulmonary tuberculosis and connective tissue lung disease. 【Conclusion】TBLB is a good method to diagnose DLD, for its higher diagnostic rate, fewer complications and smaller damage. Corroborate clinical, laboratory, radiologic and pathologic results are very important for a definitive diagnosis of diffuse DLD. The level of CRP could be used as a good index for diagnosis and therapy.

关 键 词：弥漫性肺疾病 TBLB HRCT CRP 

分 类 号：R655.3[医药卫生—外科学]