儿童间质性肺疾病2例报告并文献复习

Interstitial lung disease in children:a report of two cases and review of literature

目的总结间质性肺疾病的诊断,旨在引起临床重视。方法回顾性分析2例按临床-放射-病理学(CRP)模式确诊的儿童间质性肺疾病病例,探讨其临床特征、胸部影像学特征及病理学表现。结果 2例患儿均有咳嗽、气促,但均无杵状指趾。病原学检查无感染证据,也无结缔组织疾病证据。胸部高分辨CT均见磨玻璃影和囊泡影。经开胸肺活检,1例诊断为类脂性肺炎,1例为脱屑性间质性肺炎。结论儿童间质性肺疾病无特征性临床表现,对病情迁延、常规治疗效果不明显的患儿,应警惕间质性肺疾病。

Objective To explore the importance of lung biopsy in diagnosis of interstitial lung disease.Methods Two cases of interstitial lung disease in children,diagnosed by pathological examination,were reviewed and analyzed retrospectively.Their clinical features,chest radiology and pathology were studied.The final diagnosis was made based on the principle of clinico-radiologic-pathologic diagnosis(C-R-P).Results Two patients presented with cough and shortness of breath,no clubbing of fingers and toes observed.Ground-glass opacities and vesicles shadow were presented under high resolution CT.Neither the evidence of microbial infection nor connective tissue disease was found.In this case,lung biopsies were needed to identify the causes of the infection.The final diagnoses were made after lung biopsy that one child was lipid pneumonia and another one was desquamative interstitial pneumonia.Conclusions The respiratory symptoms of interstitial lung disease in children include cough,wheezing and shortness of breath.For those children who do not show obvious effect after conventional treatment physician should consider the possibility of interstitial lung disease.