非特异性间质性肺炎6例临床分析  

Clinical characteristics of six patients of nonspecific interstitial pneumonia

作　　者：王增智[1] 高杨[1] 李杰[1] 高元明[1] 张向峰[1] WANG Zengzhi;GAO Yang;LI Jie;GAO Yuanming;ZHANG Xiangfeng(Department of Pulmonary and Critical Care Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所呼吸与危重症医学科,100029

出　　处：《心肺血管病杂志》2022年第10期1066-1070,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨非特异性间质性肺炎(NSIP)患者的临床特点,以提高临床医生对本病的认识。方法:回顾性分析首都医科大学附属北京安贞医院,2016年1月1日至2022年6月30日,住院确诊的NSIP6例,对其临床症状和体征、胸部高分辨CT(HRCT)表现、肺功能、经气管镜肺泡灌洗液和肺活检以及诊治和预后的资料进行分析。结果:共纳入6例NSIP患者,男性4例,女性2例,年龄为55~69岁,平均年龄(63.5±6.1)岁,3例有吸烟史。3例患者出现呼吸困难,肺部查体3例存在爆裂音。5例肺功能存在弥散功能障碍和限制性通气功能障碍。6例患者HRCT中,4例出现磨玻璃影,5例网格影,4例实变影。6例气管镜肺泡灌洗液(BALF)细胞分类提示淋巴细胞比例均有升高,1例行经支气管镜冷冻肺活检(TBCB),病理组织获取满意。6例患者均经糖皮质激素治疗,随访4个月~5年,5例无复发,1例死亡。结论:HRCT表现为双下肺网格影和牵张性支气管扩张以及BALF淋巴细胞比例升高对本病有辅助诊断价值,确诊需要病理,TBCB可能会是高质量肺组织病理的获取方式,大部分患者对糖皮质激素治疗有效。Objective:To analyze the clinical characteristics of nonspecific interstitial pneumonia(NSIP) and to improve the understanding of this disease.Methods:6 patients diagnosed with NSIP,hospitalized in the department of pulmonary and critical care medicine,Beijing Anzhen Hospital,Capital Medical University from January 1st,2016 to June 30th,2022,were recruited retrospectively.Demographic data,clinic characteristics,high-resolution computed tomography(HRCT),lung function,bronchoscopic bronchoalveolar lavage fluid(BALF)and lung biopsy,treatment and prognosis of these patients were analyzed.Results:Among 6 patients,4 were males and 2 were females,aged from 55 to 69 years,with an average age of(63.5±6.1)years,and 3patients had smoking history.3 cases suffered from dyspnea,and 3 with crackles on lung examination.Diffusing and restrictive ventilatory dysfunction from lung function test were found in 5 cases.In terms of HRCT,4 had ground-glass opacity,5 had reticular pattern and 4 had consolidation pattern.It showed that lymphocytes were elevated in BALF of all 6 cases,1 case underwent transbronchial cryobiopsy(TBCB)and its pathological result was satisfactory.All patients were treated with glucocorticoid with follow up from 4 months to 5 years while 5 patients had no recurrence and 1 died.Conclusions:Bilateral reticular pattern,traction bronchiectasis in lower zones of HRCT and increased proportion of lymphocytes in BALF had the auxiliary value for the diagnosis of NSIP.Pathological results were required for diagnosis.TBCB may be the better way to obtain high-quality histopathological findings and most patients respond to glucocorticoid therapy.

关 键 词：非特异性间质性肺炎 诊断 病理 

分 类 号：R56[医药卫生—呼吸系统]