肺泡蛋白沉积症34例临床诊治分析

发布时间：2019-01-23 15:44

【摘要】：目的通过分析肺泡蛋白沉积症(PAP)病例,提高该病的诊疗水平,为PAP的临床研究提供参考。方法回顾性分析湖南省职业病防治院2008年5月至2015年6月确诊的34例PAP患者的临床资料。结果 34例中有18例(52.9%)患者有不同粉尘吸入史。咳嗽、进行性呼吸困难是PAP常见的临床症状。低氧血症和肺功能损害分别达到87.9%和90.9%。胸部高分辨CT呈铺路石样、地图样分布的特征性改变可提示诊断。34例患者均予以大容量全肺灌洗治疗,动脉血氧分压由(62.5±12.9)mm Hg上升至(76.0±12.2)mm Hg,DLCO占预计值百分比从(50.1±14.9)%上升至(64.6±14.4)%。动脉血氧和肺功能与灌洗前比较均明显改善(P0.01)。有13例患者复发,复发率为38.2%。结论 PAP病因未明,粉尘吸入暴露与PAP的发病可能有关系。大容量全肺灌洗临床治疗效果显著,但容易复发。PAP病因治疗上还需进一步研究。
[Abstract]:Objective to improve the diagnosis and treatment of pulmonary alveolar proteinosis (PAP) by analyzing the case of PAP. Methods the clinical data of 34 patients with PAP diagnosed from May 2008 to June 2015 in Hunan Provincial Hospital for the Prevention and Control of Occupational Diseases were retrospectively analyzed. Results 18 out of 34 patients (52.9%) had different dust inhalation history. Cough and progressive dyspnea are common clinical symptoms of PAP. Hypoxemia and lung function damage were 87.9% and 90.9%, respectively. Chest high-resolution CT showed paving stone, and the characteristic changes of map distribution could indicate the diagnosis. Thirty-four patients were treated with large volume whole lung lavage, and the partial pressure of oxygen in arterial blood increased from (62.5 卤12.9) mm Hg) to (76.0 卤12.2) mm Hg,). The percentage of DLCO in predicted value increased from (50.1 卤14.9)% to (64.6 卤14.4)%. Arterial blood oxygen and pulmonary function were significantly improved compared with those before lavage (P0.01). The recurrence rate was 38.2% in 13 patients. Conclusion the etiology of PAP is unknown. Dust inhalation exposure may be associated with the pathogenesis of PAP. The clinical effect of large volume whole lung lavage is remarkable, but it is easy to recur. The etiology and treatment of PAP need further study.
【作者单位】：湖南省职业病防治院;
【基金】：湖南省225高层次卫生人才培养基金
【分类号】：R563.9

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