隐源性机化性肺炎多次复发2例并复发因素文献复习  

Relapses of cryptogenic organizing pneumonia:2 cases report and literature review on relapse factors

作　　者：于鸿敏[1] 乔华[1] 张向宁[1] Yu Hongmin;Qiao Hua;Zhang Xiangning(Department of Respiratory Medicine,the First Hospital of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院呼吸内科,066000

出　　处：《国际呼吸杂志》2019年第10期767-771,共5页International Journal of Respiration

摘　　要：目的通过2例复发性隐源性机化性肺炎(COP)的临床病例报道及分析,提高对COP复发因素的认识。方法报道多次复发的COP2例,并结合相关文献进行分析。结果2例COP患者均通过CT引导下肺穿刺活检明确诊断,且在激素减量过程中出现复发,其中1例出现多次复发,激素治疗有效,总体预后良好。结论COP临床表现不典型,诊断依靠病理;肺泡灌洗液中中性粒细胞比例升高及双肺病变可能是预测机化性肺炎复发的重要指标,并可指导临床激素用量。Objective To improve the understanding of the influencing factors on relapses of cryptogenic organizing pneumonia(COP),two cases of the diagnosis and treatments about COP were introduced and analyzed.Methods Two cases of relapsing COP were reported,and the related literatures were analyzed.Results Two patients with COP were diagnosed by CT-guided lung biopsy,and the relapse occurred in the course of corticosteroids reduction.One patient had frequent relapse.The corticosteroids therapy was effective and the overall prognosis was good.Conclusions Clinical manifestations of COP are atypical,and the diagnosis depends on lung biopsy.A high neutrophil percentage in the bronchoalveolar lavage(BAL)and bilateralshadow pattern may be predictive factors of the organizing pneumonia(OP)relapse,which can guide the dosage of clinical corticosteroids.

关 键 词：肺炎 复发 诊断 

分 类 号：R563.1[医药卫生—呼吸系统]