摘要
目的通过收集2例隐源性机化性肺炎(cryptogenic organizing pneumonia,COP)患者的临床资料,并对文献报道的病例进行回顾分析,总结COP的临床、影像学、病理学、转归与预后等特点,以指导临床实践。方法收集自2016年11月-2017年1月经皮肺组织穿刺活检病理明确诊断的2例COP患者的临床资料,并检索我国近年来报道的病例,对其临床表现、影像学特点、病理改变、实验室检查等进行综合分析。结果 2例患者均经病理确诊为COP,均以咳嗽、咳痰、发热、咯血等为主要临床表现。肺部CT表现为多肺叶受累、形态多样,有实变影、渗出影、索条影、团状影、空洞影,均伴有胸腔积液。肺组织病理显示肺组织间质性肺炎伴基纤母细胞增生、变性,间质纤维组织增生,符合机化性肺炎。结论 COP是"临床-影像-病理"综合分析的过程,其预后良好,但临床上漏诊、误诊率高,及早确诊及治疗能显著改善患者的预后及减少疾病的复发。
Objective To collect the clinical data of 2 patients with cryptogenic organizing pneumonia(COP),and to review and analyze the reported cases in China,and to summarize the clinical,imaging,pathological,prognosis and prognosis of COP,in order to guide the clinical practice.Methods The clinical data of 2 cases of COP patients diagnosed by percutaneous lung biopsy from November 2016 to January2017 were collected.The clinical manifestations,imaging features and pathological changes of the patients and laboratory examination of the cases reported in recent years in China were analyzed.Results All the patients were diagnosed as COP by pathology.The main clinical manifestations were cough,expectoration,fever and hemoptysis.The CT findings of the lung were multiple lobes involvement,multiple morphologies,solid shadow,exudation,cable shadow,mass shadow,cavitation shadow,all accompanied by pleural effusion.Lung histopathology showed pulmonary interstitial pneumonia with basal fibroblast proliferation,degeneration and interstitial fibrous hyperplasia.The reaction was good after glucocorticoid treatment.Conclusion COP is a comprehensive analysis process of clinicopathology,and its prognosis is good.but clinical misdiagnosis,high misdiagnosis rate,early diagnosis and treatment can significantly improve the prognosis and reduce the recurrence of the disease.
作者
马红
杨惠琴
李冬
同立宏
MA Hong;YANG Huiqin;LI Dong;TONG Lihong(Department of Hospital Infection Management,AffiliatedTraditional Chinese Medicine Hospital,Xinjiang Medical University,Urumqi 830000,China;Department of Respiratory Medicine,Affiliated Traditional Chinese Medicine Hospital,Xinjiang Medical University,Urumqi 830000,China;Department of Traditional Chinese Medicine,Yunyang County People′s Hospital,Yunyang,Chongqing 404500,China)
出处
《新疆医科大学学报》
CAS
2018年第8期967-970,共4页
Journal of Xinjiang Medical University
基金
国家中医药管理局国家中医临床研究基地业务建设科研专项课题(JDZX20151235)
关键词
隐源性机化性肺炎
病理学
影像学
诊断
治疗
cryptogenic organized pneumonia
pathology
imaging
diagnosis
treatment