6例外源性过敏性肺泡炎的临床分析

发布时间：2019-01-16 04:59

【摘要】：目的：探讨外源性过敏性肺泡炎(EAA)的临床表现、影像学特点及诊断治疗。方法：回顾分析2009年10月至2012年3月浙江大学医学院附属第一医院呼吸科诊断为外源性过敏性肺泡炎的住院患者6例,总结其临床表现、影像学特点、诊断及治疗情况。结果： 6例患者中4例有较明确的过敏原接触环境。6例患者均因不同程度的临床症状而就诊,主要症状为咳嗽、咳痰、发热和胸闷气促。肺部CT表现多样,有两肺多发结节状稍高密度影,两肺弥漫性斑片状或磨玻璃样影,两肺弥漫性粟粒灶,条索状致密影等。其中4例有总IgE升高,2例IgA和IgG升高。5例患者确诊或可疑EAA后使用糖皮质激素治疗,1例使用脱离接触环境治疗,6例患者均有临床症状缓解或影像学上好转。结论：外源性过敏性肺泡炎多有过敏原接触史,临床表现特异性低,影像学表现多样。提高早期确诊率、及时使用糖皮质激素治疗可以提高疾病预后。
[Abstract]:Objective: to investigate the clinical manifestations, imaging features and diagnosis and treatment of exogenous allergic alveolitis (EAA). Methods: from October 2009 to March 2012, 6 inpatients diagnosed as exogenous allergic alveolitis in the Department of Respiratory, first affiliated Hospital of Zhejiang University Medical College were retrospectively analyzed, and their clinical manifestations, imaging features, diagnosis and treatment were summarized. Results: 4 out of 6 patients had definite allergen contact environment, 6 patients were treated with different clinical symptoms, the main symptoms were cough, expectoration, fever and chest tightness. Pulmonary CT showed multiple nodular hyperdense shadows in both lungs, diffuse plaques or ground-glass shadows in both lungs, diffuse miliary foci in both lungs, and stripe dense shadows, and so on. Of them, 4 cases had elevated total IgE, 2 cases had increased IgA and IgG, 5 cases had been treated with glucocorticoid after diagnosed or suspected EAA, 1 case had been treated with disengagement environment, and 6 cases had clinical symptom relief or imaging improvement. Conclusion: exogenous allergic alveolitis has a history of exposure to allergens, with low specificity and multiple imaging manifestations. Early diagnosis and timely use of glucocorticoid can improve the prognosis of the disease.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R563.1

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