慢性嗜酸性粒细胞性肺炎五例临床分析

发布时间：2018-05-31 15:14

本文选题：慢性嗜酸性粒细胞性肺炎 + 诊断　；参考：《中国呼吸与危重监护杂志》2017年03期

【摘要】：目的总结慢性嗜酸性粒细胞性肺炎的临床特点、诊断及治疗方法,提高诊治水平。方法回顾性分析2011年1月至2015年1月5例慢性嗜酸性粒细胞性肺炎患者的临床资料。结果患者中男2例,女3例。合并过敏性鼻炎1例,合并支气管哮喘2例,具有过敏史者2例,合并变应性皮疹1例。主要临床表现为发热、咳嗽、咯痰、呼吸困难和胸痛,常伴乏力、纳差和体重下降。主要体征为两肺湿Up音、散在哮鸣音,亦可闻及爆裂音。5例均有外周血嗜酸性粒细胞计数升高,嗜酸性粒细胞百分比升高,支气管肺泡灌洗液中嗜酸性粒细胞百分比明显升高。主要影像表现为两肺浸润影,斑片实变影和磨玻璃影。5例均接受糖皮质激素治疗。随访中病情复发1例。结论慢性嗜酸性粒细胞性肺炎起病隐匿,临床表现缺乏特异性,常合并哮喘及变应性皮炎,多数患者外周血和肺泡灌洗液嗜酸性粒细胞数明显升高,典型影像表现为周边和胸膜下分布为主的肺浸润影。
[Abstract]:Objective to summarize the clinical features, diagnosis and treatment of chronic eosinophil pneumonia. Methods the clinical data of 5 patients with chronic eosinophil pneumonia from January 2011 to January 2015 were retrospectively analyzed. Results there were 2 males and 3 females. There were 1 case with allergic rhinitis, 2 cases with bronchial asthma, 2 cases with allergic history and 1 case with allergic rash. The main clinical manifestations are fever, cough, sputum, dyspnea and chest pain, often accompanied by fatigue, anorexia and weight loss. The main signs were wet up in both lungs, wheezing scattered, and buzzer. The eosinophil count, eosinophil percentage and eosinophil percentage in bronchoalveolar lavage fluid were all increased in 5 cases of eosinophil count in peripheral blood, and the percentage of eosinophil in bronchoalveolar lavage fluid was obviously increased. The main imaging findings were pulmonary infiltration, macular consolidation and glass-grinding. 5 cases were treated with glucocorticoid. Recurrence occurred in 1 case during follow-up. Conclusion chronic eosinophil pneumonia is characterized by occult onset and lack of specificity in clinical manifestations. It is often associated with asthma and allergic dermatitis. The number of eosinophils in peripheral blood and alveolar lavage fluid is significantly increased in most patients. Typical imaging features were pulmonary infiltrating shadows mainly distributed in peripheral and subpleural areas.
【作者单位】：上海交通大学医学院附属新华医院呼吸科;上海交通大学医学院附属新华医院病理科;
【分类号】：R563.1

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