慢性嗜酸性粒细胞肺炎90例临床荟萃分析  

Chronic Eosinophilic Pneumonia:a Clinical Meta-analysis of 90 Cases

作　　者：张威 王珺[2] 蔡成森[2] 于健健 刘玉霞[2] ZHANG Wei;WANG Jun;CAI Chengsen;YU Jianjian;LIU Yuxia(Shandong University of Traditional Chinese Medicine,Jinan 250014,China;Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250001,China)

机构地区：[1]山东中医药大学,山东省济南市250014 [2]山东中医药大学第二附属医院呼吸与危重症医学科,山东省济南市250001

出　　处：《实用心脑肺血管病杂志》2021年第1期65-70,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：背景慢性嗜酸性粒细胞肺炎(CEP)是一种少见的肺部疾病,临床表现缺乏特异性,易被误诊。目前关于CEP的文献多为临床病例报道,缺乏对该疾病的系统总结。目的荟萃分析CEP患者的临床特征,以为广大临床医生提供参考,提高其临床诊治水平。方法检索中文数据库〔万方数据知识服务平台、中国知网(CNKI)〕以及英文数据库(PubMed)中有关CEP的病例报告,检索时限为建库至2020年1月。根据文献纳入与排除标准,由两名研究员筛选文献,并提取相关内容,包括患者一般资料(性别、年龄、病程、既往病史)、临床表现、影像学(胸部CT检查)特征(包括病变部位、病变征象)、实验室检查结果、肺活检病理检查结果、肺功能检查结果、治疗与转归。结果最终共纳入53篇文献,共计90例患者。90例患者中,男女比为1.0∶1.6,平均年龄(43.2±10.6)岁;临床表现主要为咳嗽80例(88.9%),呼吸困难56例(62.2%),发热48例(53.3%);有88例患者进行了胸部CT检查,其中病变部位主要为双肺65例(73.9%),病变征象主要为浸润性阴影33例(37.5%)、磨玻璃影30例(34.1%)、斑片实变影28例(31.8%);有79例患者检测了外周血嗜酸粒细胞(EOS)计数,其中升高73例(92.4%);有47例患者检测了外周血总免疫球蛋白E(IgE)抗体水平,其中升高36例(76.6%);11例患者检测了痰液EOS计数,其中升高11例(100.0%);有62例患者检测了支气管肺泡灌洗液(BALF)EOS分数,其中升高58例(93.5%);有33例患者进行了肺活检病理检查,其中EOS浸润29例(87.9%);有35例患者进行了肺功能检查,其中正常9例(25.7%),限制性通气功能障碍11例(31.4%),阻塞性通气功能障碍8例(22.9%),混合性通气功能障碍7例(20.0%),弥散功能障碍7例(20.0%);口服糖皮质激素治疗85例(94.4%),口服糖皮质激素联合IgE单抗治疗3例(3.3%),自愈2例(2.2%);复发23例(26.1%)(其中使用糖皮质激素治疗3~12个月者9例、<3个月或>12个月者14例);未复�Background Chronic eosinophil pneumonia(CEP)is a rare pulmonary disease,which is lack of typical clinical manifestations and easy to be misdiagnosed.At present,many literatures about CEP are clinical case reports,there is a lack of systematic summary of the disease.Objective To analyze the clinical manifestations for providing reference to clinicians and improving their clinical diagnosis and treatment level.Methods Chinese database(Wanfang Data,CNKI)and English database(PubMed)were researched to find case reports on CEP.The search time was from the establishment of the database to January 2020.According to the inclusion and exclusion criteria,two researchers screened literatures and extracted the relevant contents,including general information(gender,age,course of the disease,past medical history),clinical manifestations,imaging(chest CT examination)characteristics(lesion site,lesion signs),laboratory examination results,pathological examination results of lung biopsy,pulmonary function test results,treatment and outcome.Results A total of 53 articles were included and a total of 90 patients were included.Among the 90 patients,the ratio of male to female was 1.0∶1.6,and the mean age was(43.2±10.6)years.The main clinical manifestations mainly were cough in 80 cases(88.9%),dyspnea in 56 cases(62.2%)and fever in 48 cases(53.3%).Chest CT examination was performed in 88 patients,including 65 patients(73.9%)with bilateral lung lesions,33 patients(37.5%)with invasive shadow,30 patients(34.1%)with ground glass shadow,and 28 patients(31.8%)with patch consolidation shadow.Eosinophils(EOS)counts of peripheral blood were detected in 79 patients,among whom 73 cases(92.4%)increased.Total immunoglobulin E(IgE)antibody level in peripheral blood was detected in 47 patients,among which 36 cases(76.6%)elevated.Sputum EOS counts were measured in 11 patients,of whom 11 cases(100.0%)elevated.EOS scores of bronchoalveolar lavage fluid(BALF)were measured in 62 patients,of whom 58 cases(93.5%)elevated.Pathological examination of lung

关 键 词：肺嗜酸粒细胞增多 嗜酸细胞性肺炎 嗜酸粒细胞增多 荟萃分析 

分 类 号：R563.1[医药卫生—呼吸系统]