| 王剑,陈清勇,何聪,张晓敏,徐炜.隐源性机化性肺炎1例并文献复习[J].浙江中西医结合杂志,2015,25(1): |
| 隐源性机化性肺炎1例并文献复习 |
| one cases of cryptogenic organizing pneumonia and review |
| 投稿时间：2014-04-18 修订日期：2015-01-05 |
| DOI： |
| 中文关键词: 隐源性机化性肺炎 影像学 糖皮质激素 大环内酯类 |
| 英文关键词:cryptogenic organizing pneumonia imaging manifestations corticoste- |
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| 中文摘要: |
| 目的 探讨和提高对隐源性机化性肺炎（cryptogenic organizing pneumonia，COP）的认识和诊治能力，了解该疾病在国内外的一些诊治进展。方法 对2例经病理证实的COP患者临床资料进行回顾，复习国内外文献，探讨COP的临床表现、影像学改变、病理学改变等特点。结果 2例COP患者均为女 性，亚急性起病，以发热、咳嗽、咳痰为主要临床症状，入院均被误诊为CAP，一般实验室检查无明显特异性，影像学表现多样性，呈多肺叶实变影伴支气管充气征、磨玻璃影、条索状影，病变呈游走性，抗生素治疗无效，经皮肺穿刺活检确诊，使用糖皮质激素治疗效果良好。结论 COP诊断需结合临床表现、影像学改变、病理学诊断，激素是治疗COP的有效药物，大环内酯类和某些免疫抑制剂可能替代或辅助激素治疗。 |
| 英文摘要: |
| Objective To analyze and improve the ability of diagnosis and treatment in patients with cryptogenic organizing pneumonia(COP),to learn the advances in diagnosis and treatment of COP at home and abroad. Methods The clinic data of the pathologically proved 2 cases COP were analyzed and the literatures including clinical manifestation, CT scan and pulmonary histopathoiogical characteristics of COP were reviewed. Results The most common symptoms of the 2 female patients were fever, cough and expectoration. CT scan showed alveolar consolidation with air bronchogram, ground glass opacities and fibrous bundles. Hormonotherapy was used before the COP was diagnosed by percutaneous lung biopsy and remarkable response was found. Conclusions The diagnosis of COP is suggested by clinical characteristics, radiological findings and histopathologically. Corticosteroids is the most effective drug for treating COP. Macrolides and some immunodepresseurs can be used as corticosteroids adjuvant therapy. |
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