寄生虫感染相关嗜酸粒细胞增多相关性肺疾病的临床特征分析  

Clinical characteristics analysis of parasitic infection-associated eosinophilic pulmonary disease

作　　者：袁丁 马宇雯 戴妹 薛玲娜 欧昌星 廖永康 张清玲 Yuan Ding;Ma Yuwen;Dai Mei;Xue Lingna;Ou Changxing;Liao Yongkang;Zhang Qingling(State Key Laboratory of Respiratory Disease,National Clinical Research Center for Respiratory Disease,National Center for Respiratory Medicine,Department of Pulmonary and Critical Care Medicine,Guangzhou Institute of Respiratory Health,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]呼吸疾病全国重点实验室/国家呼吸系统疾病临床医学研究中心/国家呼吸医学中心呼吸与危重症医学科广州呼吸健康研究院/广州医科大学附属第一医院/广州医科大学,广州510120

出　　处：《国际呼吸杂志》2024年第2期184-191,共8页International Journal of Respiration

基　　金：广东省钟南山医学基金(ZNSA-2020013);广州医科大学科技创新项目(2022A015);广州医科大学本科生创新能力提升计划项目(02-408-2304-01023XM);广州市重大疑难疾病中西医协同治疗示范单位建设项目。

摘　　要：目的分析寄生虫感染相关嗜酸粒细胞增多相关性肺疾病(EPD)的临床特征。方法横断面研究,采用目的抽样法收集2021年5月至2022年12月在广州医科大学附属第一医院诊断为寄生虫感染EPD患者25例的资料,根据国家寄生虫病卫生行业标准将其分为临床诊断组17例和确诊组8例,比较2组患者的流行病学史、人口学特征、临床表现及相关检查指标,随访患者驱虫治疗的效果。结果临床诊断组外周血嗜酸性粒细胞(EOS)显著高于确诊组,EOS重度升高的患者比例也更高(P=0.026)。2组患者肺影像学主要改变为磨玻璃样、结节样、间质增厚。2组患者接受驱虫治疗后症状均好转,17例患者驱虫治疗后复查血EOS较治疗前下降(Z=3.20,P=0.006),其中的8例患者在治疗后第1个月即可看到血EOS的显著下降(Z=2.52,P=0.012)。结论寄生虫感染相关EPD可以表现为外周血EOS重度升高,其病原学检出率不高,流行病学史的采集对于疾病诊断十分重要。对于有寄生虫病流行病学史、寄生虫抗体阳性、无肺外器官受累的EPD患者,诊断性驱虫治疗可以提高预后。Objective To analyze the clinical characteristics of eosinophilic pulmonary disease(EPD)associated with parasitic infections,in order to provide a theoretical basis for early intervention and improved prognosis.Methods This was a cross-sectional studyusing purposive sampling to collect data from 25 patients diagnosed with parasitic infection-associated EPD at the First Affiliated Hospital of Guangzhou Medical University from May 2021 to December 2022.According to the national parasitic disease health industry standards,patients were divided into clinical diagnostic group(17 cases)and confirmed group(8 cases).Epidemiological history,demographic characteristics,clinical manifestations,and relevant examination indicators of the patients were collected and compared,and the effectiveness of deworming treatment was followed up.Results The peripheral blood eosinophils(EOS)in the clinical diagnostic group were significantly higher than those in the confirmed group,with higher proportion of patients with severe EOS elevation(P=0.026).The main changes in lung imaging for both groups were ground-glass opacity,nodular opacity,and interstitial thickening.After deworming treatment,symptoms improved in all patients,and in 17 cases,the blood EOS decreased after treatment(Z=3.20;P=0.006),with 8 patients showing a significant decrease in blood EOS in the first month after treatment(Z=2.52;P=0.012).Conclusions Parasitic infection-associated EPD can present as severe peripheral blood eosinophilia,with a low pathogen detection rate,making the collection of epidemiological history crucial for disease diagnosis.For EPD patients with a history of parasitic disease epidemiology,positive parasitic antibodies,and no involvement of extrapulmonary organs,diagnostic deworming treatment can improve prognosis.

关 键 词：肺疾病 寄生虫性 嗜酸性粒细胞增多 诊断性治疗 流行病学 

分 类 号：R53[医药卫生—内科学] R563[医药卫生—临床医学]