隐源性和继发性机化性肺炎临床和影像学特点分析

Analysis for clinical and radiologic distinctions between cryptogenic organizing pneumonia and secondary organizing pneumonia

目的了解机化性肺炎（OP）的临床特点，比较隐源性机化性肺炎（d）P）和继发性机化性肺炎（SOP）在临床表现、影像学表现及对糖皮质激素治疗反应方面的差异。方法回顾性分析自2002年7月--2011年5月本院43例OP患者的临床资料。结果与COP患者相比，SOP患者人院前的病程更短（P〈0．01），更易出现发热症状（538％VS20．0％）和捻发音体征（61．5％VS40．0％）。胸腔积液仅发现于SOP患者，与COP患者卡H比具有显著性差异（P〈0．01）。OP患者对糖皮质激素治疗有效率90．7%，4例死亡病例均为多肌炎／皮肌炎患者。结论SOP患者临床表现更为多样，OP和多肌炎／皮肌炎并存预后差。

Objective To investigate the clinical features of organizing pneumonia （OP） and the difference between cryptogenic organizing pneumonia （COP） and secondary organizing pneumonia （SOP） in clinical manifection, raidologic manifecion and response to glucocorticoid therapy. Methods A retrospective study of 43 patients with OP from July 2002 to May 2011 was conducted. Results Compared to COP, SOP reported shorter duration of symptoms before admission （P 〈 0.01）, fever （53.8 % vs 20.0 % ） and crackles（61.5 % vs 40.0 % ） more frequently. Pleural effusion was present in 38 % patients with SOP, whereas none of the patients with COP had effusion （P 〈 0.01）. Among patients of OP, 90.7 % responded to treatment with corticosteroids. The four fatal cases were all polymyositis/dermatomyostits patients. Conclusion Patients with SOP are more symptomatic. Patients with OP and polymyositis/dermatomyositis have worse prognosis.