隐源性机化性肺炎的临床诊治探讨

Clinical diagnosis and treatment of cryptogenic organizing pneumonia

目的探讨隐源性机化性肺炎(COP)的临床诊治思路及经纤支镜支气管肺活检术(TBLB)的诊断价值。方法对1例最初被确诊为"肺部感染"并使用多种抗生素治疗无效的男性患者,采用TBLB方式,对其病理学检查结果进行分析,确诊为COP,给予泼尼松治疗,规律药物减量,追踪随访。结果激素治疗效果良好,但先后2次药物减量过程中病情复发,经再次加大药物剂量,患者症状缓解,病情稳定。随访2年,至撰稿日仍予激素维持量治疗。结论隐源性机化性肺炎(COP)的临床及影像学表现特异性差,确诊需病理活组织检查证据,可按照病变部位情况选择活检方式。对COP应用激素治疗反应好,但易复发。

Objective To investigate the clinical diagnosis and treatment of cryptogenic organizing pneumonia （COP） and diagnostic value of transbronchial lung biopsy （TBLB）. Methods A case was initially diagnosed as “Pulmonary infection” and given a variety of antibiotic therapy. After TBLB to analyze the results of its pathology, it was diagnosed with COP, given prednisone therapy and reduction regularly, followed up. Results The effect of hormone therapy followed with good results, but had relapsed twice in the reduction process of drug. By increasing the dose again, the symptoms became stable. The patient keeps maintenance dose of hormone therapy to now. Conclusion Cryptogenic Organizing Pneumonia （COP） clinical manifestations and imaging shows poor specificity and pathological diagnosis requires a biopsy evidence. Select the situation in accordance with the lesion biopsy methods. Hormone treatment responses well, but easy to relapse.