肺泡蛋白沉积症十例临床分析及全肺灌洗治疗体会

Clinical analysis and whole lung lavage in 10 patients with pulmonary alveolar proteinosis

目的总结肺泡蛋白沉积症(PAP)的临床资料以及全肺灌洗的疗效和安全性,丰富PAP的诊治经验。方法10例PAP患者,经支气管肺活检(TBLB)和支气管肺泡灌洗液(BALF)过碘酸夫雪(PAS)染色检查确诊,均行全肺灌洗治疗。结果10例PAP患者均表现为渐进性呼吸困难。肺部高分辨率CT有特征的毛玻璃样改变,全肺灌洗治疗后临床症状、肺功能、动脉血气及高分辨率CT等指标均显著改善。结论渐进性呼吸困难和毛玻璃样在高分辨率CT改变是PAP患者的最重要临床特征,大容量全肺灌洗治疗PAP安全有效。

Objective To summarize climcal matenal and evalute treatment ot whole lung lavage in patients with pulmonary alveolar proteinosis（PAP）. Methods A retrospective analysis was conducted of 10 patients with PAP who were identified by transbronchial lung biopsy（TBLB） and periodic acid-shift （PAS） staining of brocho-alveolar lavage fluid（BALF） and given whole lung lavage. Results 10 patients who manifested progressive dyspnea,hypoxidosis and ground -glass opacity of lung on high-resolution CT （HRCT） were relieved from dyspnea and lung function after whole lung lavage, PaO2 and HRCT were improved significantly, Conclusion Progressing dyspnea and ground-glass opacity of lung on HRCT are the most significant clinical characteristics in patients with PAP. Whole lung lavage is an effective and safe way to treat the patients.