药源性肺炎的诊断与临床特点(16例报告及文献复习)

Clinical characteristics and diagnosis of medication pneumonia

目的探讨药源性肺炎的诊断及其临床表现特点。材料和方法收集16例西药引起的肺炎病例,分析其临床。结果 16例中男7例女9例,平均年龄58.5岁,其中11例有肺部基础性疾病。7例有抗生素和生物制剂、9例有化疗药物使用史。临床表现为咳嗽发热9例,4例同时并有呼吸困难,无明显症状3例。放射学表现为大片状边缘模糊的磨玻璃阴影9例,沿肺纹理分布的索条状及结节状影7例。血清KL26和SP2D均升高者10例。结论药源性肺炎表现为非特异性间质性肺炎,并需排除类似表现的非药源性肺炎。

Objective To study the clinical characteristic and diagnosis of medication pneumonia.Methods 16 cases with medication pneumonia resulted from western medicine were collected in order to analyze their clinical features,radiological findings and laboratory results.Results 16 cases with the average age were 58.5 years old,7 were men and 9 were women.11 of 16 cases had basic diseases before medication pneumonia.7 cases had been used antibiotics and biological agent while 9 cases had been used chemotherapy drugs.9 of 16 patients appeared cough and fever while 4 cases occurred dyspnea meanwhile.3 of 16 cases had no special symptoms.9 of 16 cases had big shaped grinding glasses with fuzzy edge in radiological films,and 7 patient＇s film showed irregular strip and nodules shape distributed along lung vessels texture.10 of 16 cases had higher lever on the KL26 and SP2D in the serum exams.Conclusion Medication pneumonia is actually nonspecific interstitial pneumonia.It may be easily occurred in the patients with old age as well as along with lung basic diseases when using the induced drugs.Medication pneumonia has no characteristics on the clinical and accessory examination.The diagnosis must be done synthetically,and further,it should be given the exclusion of non medication pneumonia before the positive diagnosis.