老年尸检机化性肺炎临床病理分析  

Clinicopathologic analysis of organizing pneumonia in elderly autopsies

作　　者：方芳[1] 林凤如[1] 李惠章[2] 

机构地区：[1]北京医院病理科,100730 [2]北京医院放射科,100730

出　　处：《中华病理学杂志》2004年第2期113-116,共4页Chinese Journal of Pathology

摘　　要：目的 探讨老年尸体解剖中遇到的机化性肺炎的临床病理特点及其可能的原因。方法从1980-2003年635例老年人尸检资料中检出95例机化性肺炎,观察机化性肺炎的形态特点,并对其临床资料和影像学变化进行回顾分析。结果 机化性肺炎大多数病灶小、散在,经常出现在主要肺部疾病附近,不同病变相伴的机化性肺炎其病变特点也略有差别;95例机化性肺炎周围的主要肺部疾病有:(1)化脓性肺炎及肺脓肿以及慢性复发性肺炎(36例);(2)感染性疾病(真菌、病毒等17例);(3)吸人性肺炎(16例);(4)放射性肺炎(5例);资料还显示慢性胸膜炎、肺不张也常与机化性肺炎相伴。机化性肺炎肺部病变影像学表现呈多样性。结论 老年尸检中机化性肺炎是常见的伴发病变,与多种疾病相关,各种原因伴发的机化性肺炎形态学上大致相似。在相关因素分析中认为老年性机化性肺炎主要与细菌、真菌、病毒等感染有关;吸人性及放射性肺炎等也常伴发机化性肺炎。影像学上肺部感染患者长期不消散的阴影需考虑到出现机化性肺炎的可能。Objective To study the clinicopathologic characteristics of organizing pneumonia of the autopsies in elder and to analyze the possible underlying etiologic factors. Methods Ninety-five cases of organizing pneumonia were found from 635 elderly autopsy reports of the Beijing Hospital since 1980. The morphologic and imaginal features were analyzed. Results The foci of organizing pneumonia in our series were often small, patchy, scattered and adjacent to other lung lesion. There were, however, some variations in cases with different underlying conditions. The conditions associated with organizing pneumonia, as detected in our series, were: ( 1 ) 36 cases with suppurative inflammation, lung abscesses and chronic relapsing pneumonia; (2) 17 cases with fungal or viral infection; (3) 16 cases with aspiration pneumonia; (4) 5 cases with radiation pneumonia. We observed that it was not uncommon for organizing pneumonia coexisting with atelectasis and chronic pleuritis. The image of organizing pneumonia was varied. Conclusions Organizing pneumonia is a common finding in autopsies of the elder. It occurs in association with many diseases and the basic pathologic changes are similar. All of which represent secondary phenomenon. Possible etiologic factors include infection ( due to bacteria, fungi or virus) , aspiration and radiation. The possibility of organizing pneumonia should be considered if the shadow of lung is undisappeared in imagin.

关 键 词：老年 尸检 机化性肺炎 病理特点 尸体解剖 

分 类 号：R563.1[医药卫生—呼吸系统]