经纤支镜多次分段肺泡灌洗联合rhGM-CSF治疗原发性肺泡蛋白沉积症2例  

Two cases of primary pulmonary alveolar proteinosis treated with segmental alveolar lavage through fiberoptic bronchoscopy combined with subcutaneous injection of recombinant human granulocyte-macrophage colony-stimulating factor

作　　者：王西华[1] 何灿[1] WANG Xihua;HE Can(Department of Respiratory and Critical Care Medicine,Zhongda Hospital,Southeast University,Nanjing 210009,China)

机构地区：[1]东南大学附属中大医院呼吸与危重症医学科,江苏南京210009

出　　处：《东南大学学报(医学版)》2025年第1期18-22,共5页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:探讨2例肺泡蛋白沉积症(PAP)治疗的效果及安全性。方法:对本科收治的采用经纤支镜多次分段支气管肺泡灌洗(BAL)联合皮下注射重组人粒细胞-巨噬细胞集落刺激因子(rhGM-CSF)等措施治疗的2例PAP患者进行回顾性分析。结果:2例PAP患者经纤支镜多次分段BAL联合皮下注射rhGM-CSF的治疗效果确切(患者症状消失快,影像学、肺功能、血气分析等检查结果均明显改善)、副作用轻微。结论:经纤支镜多次分段BAL联合rHuGM-CSF治疗PAP安全、方便、可行,近、远期疗效好,是在不具备施行全肺灌洗术条件或患者不适合全肺灌洗术的情况下首选的治疗方法。Objective:To investigate the therapeutic efficacy and safety in 2 patients diagnosed with pulmonary alveolar proteinosis(PAP).Methods:The clinical data of 2 PAP cases who received the treatment of segmental bronchoalveolar lavage(BAL)in combined with subcutaneous injection of recombinant human granulocyte-macrophage colony-stimulating factor(rhGM-CSF)were analyzed retrospectively.Results:Following the combined treatment,both patients showed significant improvement.There were notable outcomes including rapid alleviation of symptoms,enhanced lung function,and favorable results in CT imaging and blood gas analyses.In addition,the treatment was well-tolerated merely with mild side effects.Conclusion:The combined application of BAL and rhGM-CSF in multiple segments of fiberoptic bronchoscopy is safe,convenient and feasible for treating PAP,which has good short-term and long-term efficacy and is the preferred treatment method when the whole lung lavage operation is not available or the patient is not suitable for the whole lung lavage operation.

关 键 词：肺泡蛋白沉积症 分段支气管肺泡灌洗 重组人粒细胞-巨噬细胞集落刺激因子 

分 类 号：R563.9[医药卫生—呼吸系统]