隐源性机化性肺炎16例临床分析

Clinical features of the cryptogenic organized pneumonia:retrospective analysis for the 16 patients

目的分析隐源性机化性肺炎16例患者的临床、影像和病理特征。方法在我院确诊的16例患者,对其病例资料进行分析。结果气短、咳嗽、肺部爆裂音及湿啰音为主要临床表现;肺功能检查主要为限制性通气障碍;胸部CT示肺实变为主伴间质性改变。支气管肺泡灌洗液细胞混合性增高,CD4+/CD8+降低。所有患者经肺活检证实为机化性肺炎。15例患者7.9±5.8个月仍存活、临床缓解或病情稳定;1例死于呼吸衰竭。结论临床表现及影像学特点对隐源性机化性肺炎的诊断有提示作用,但确诊仍依靠病理活检。

Objective To explore the clinical characteristics, imaging features and pathology of 16 patients with cryptogenic or- ganized pneumonia （COP）. Methods 16 patients of COP were diagnosed in Shandong chest hospital from Mary 2001 to June 2010 and their clinical performances, imaging features and biopsy results were retrospectively analyzed. Results The major clinical signs and symp- toms for all patients were shortness of breath, cough, lung auscultation crackles and wet tales. Pulmonary function test suggested there were almost restrictive ventilatory dysfunction ; the signs of computed tomography for chest were mainly lung consolidation, some with chan- ges in lung interstitial. Bronchoalveolar lavage fluid test found the increased cytomixis, but CD~/CD8 decreased. Pathological diagnosis of lung biopsy was organized pneumonia for all the cases. 15 patients were survival, clinical remission or stable disease for 7.9 ＋ 5.8 months. One patient was died of respiratory failure. Conclusions Clinical features and imaging findings are helpful for the diagnosis cryp- togenic organized pneumonia, but the chest biopsy is still only way to the final diagnosis.