隐源性机化性肺炎9例并文献复习  

Clinical features of 9 cases of cryptogenic organizing pneumonia and literature review

作　　者：王化生[1] 欧仁杰 王默[3] 白龙振 李英杰 孙超 王永梅[4] WANG Huasheng;OU Renjie;WANG Mo;BAI Longzhen;LI Yingjie;SUN Chao;WANG Yongmei(Department of Thoracic Surgery,The Second Hospital of Shandong University,Jinan 250033,Shandong,China;Department of Thoracic Surgery,The Shandong Linglong Yingcheng Hospital,Zhaoyuan 265400,Shandong,China;Department of Vascular Surgery,Shandong Provincial Hospital Affilited to Shandong University,Jinan 250021,Shandong,China;Department of Cardiology,The Second Hospital of Shandong University,Jinan 250033,Shandong,China)

机构地区：[1]山东大学第二医院胸外科,山东济南250033 [2]山东玲珑英城医院胸外科,山东招远265400 [3]山东大学附属省立医院血管外科,山东济南250021 [4]山东大学第二医院心内科,山东济南250033

出　　处：《山东大学学报（医学版）》2020年第1期81-86,共6页Journal of Shandong University:Health Sciences

摘　　要：目的探讨在临床放射学诊断上比较独特,易被误诊误治的隐源性机化性肺炎(COP)的临床特点。方法回顾性分析通过症状、病史、影像学和病理检查诊断和治疗的9例COP患者临床资料,进行总结分析。结果本级病例症状以咳嗽(66.7%)和胸闷(55.6%)多见;实验室检查示CRP(63.0±92.6)mg/L和ESR(35.5±26.3)mm/h明显升高;胸部CT以双侧或者单侧斑片状或弥漫性实变影(55.6%)多见,通常分布于肺周边部位,游走性是特征性表现;病理特点为肺泡和细支气管腔内充满疏松成纤维细胞结缔组织栓,呈圆形或哑铃形;对皮质类固醇治疗敏感,预后良好。结论COP临床症状虽不特异,但胸部影像学有特征性表现,尽早应用皮质类固醇治疗,预后良好。Objective To summarize cryptogenic orgenizing pneumonia(COP)’s clinical and radiographic features. Methods Nine cases COP were reviewed. Their clinical presentation, radiographic and pathology features were analyzed. Results Cough(66.7%) and chest tightness(55.6%) were the most common symptoms in those patients. CRP and ESR were increased distinctly. Chest CT was characterized by bilateral or unilateral patchy or dffuse con-solidation(55.6%), and migration was its characteristic radiographic feature. In pathological staining, the alveoli and bronchioles were filled with loose fibroblast connective tissue thrombus, which was round or dumbbell-shaped. COP was sen-sitive to corticosteroid therapy, and had a good outcome. Conclusion COP has its own radiographic characteristics and sensitive to corticosteroid treatment. Attention should be paid to the disease to avoid misdiagnosis and mistreatment.

关 键 词：隐源性机化性肺炎 临床特点 放射影像特征 皮质类固醇 

分 类 号：R563[医药卫生—呼吸系统]