大环内酯类药物治疗隐源性机化性肺炎一例并文献复习

发布时间：2018-04-02 14:30

本文选题：大环内酯类　切入点：隐源性机化性肺炎　出处：《中国全科医学》2014年32期

【摘要】：目的提高对大环内酯类药物治疗隐源性机化性肺炎(COP)的认识。方法报道1例使用阿奇霉素治疗COP病例的诊治经过,并进行文献复习。对万方数据库和PubMed数据库进行检索,检索时间截至2012年12月,共8篇文献入选,大环内酯类药物治疗COP患者34例。对此34例及本例患者的临床资料以及大环内酯类药物的治疗反应进行总结。结果 35例患者中20例初始即单独应用大环内酯类药物治疗,16例治愈,但病情改善时间较激素明显延长,4例治疗失败;9例联合使用大环内酯类药物治疗后病情改善;6例未评估临床疗效。大环内酯类药物不良反应少见,仅1例患者在使用克拉霉素过程中出现皮疹而停药。结论对轻症COP患者大环内酯类药物可尝试作为一线治疗药物,对在激素减量过程中或停用后反复发作患者加用大环内酯类药物可增强疗效。
[Abstract]:Objective to improve the understanding of macrolides in the treatment of cryptogenic organized pneumonia (CPP).Methods A case of COP treated with azithromycin was reported.The search time of Wanfang database and PubMed database was studied. Up to December 2012, 8 articles were selected, 34 patients with COP were treated with macrolides.The clinical data of 34 patients and the response of macrolides were summarized.Results among the 35 patients, 20 cases were initially treated with macrolides alone and 16 cases were cured.But the improvement time was significantly longer than that of hormone in 4 cases of failure of treatment and 9 cases were treated with macrolide drugs. 6 cases were not evaluated for the clinical effect after the treatment of macrolides.Adverse drug reactions of macrolides were rare, and only one patient had a rash during clarithromycin.Conclusion macrolides can be used as a first-line therapeutic drug in patients with mild COP, and the effect can be enhanced by adding macrolides in the course of hormone reduction or in patients with recurrent attacks after discontinuation.
【作者单位】：宁波大学医学院附属医院呼吸内科;
【基金】：宁波大学科研基金资助项目(XYY110003)
【分类号】：R563.1

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