隐源性机化性肺炎18例临床分析

目的 分析我院经活检确认的18例隐源性机化性肺炎患者,总结其在临床、治疗及预后方面的特点.方法 收集我院2008年1月至2012年10月间经肺活检证实的18例隐源性机化性肺炎患者的所有资料,回顾性分析本组患者的临床资料、易患因素、影像学表现、病理、实验室检查等的特点.结果 18例患者平均年龄（59±11）岁.本组18例患者临床症状主要为咳嗽、咳痰、胸闷、气短等呼吸系统症状,少数有盗汗、乏力、消瘦等全身症状.影像学表现多种多样,可有斑片影、实变影、磨玻璃样变影等,最初发病多以斑片影为主.肺功能表现为轻度限制性通气功能障碍,弥散功能受损.14例（77.8％）患者治愈,4例（22.2％）患者复发,对糖皮质激素效果较好.结论 隐源性机化性肺炎容易误诊为肺部感染,诊断需要综合临床-影像-病理三方面分析,病理具有早期指导治疗作用,但是本病预后良好.

Clinical analysis of 18 cases of cryptogenic organizing pneumonia

Objective To analyze the clinical features,therapy,and prognosis of cryptogenic organizing pneumonia （COP）.Methods Eighteen patients with COP were collected,who were confirmed by lung biopsy in PLA General Hospital from January 2008 to October 2012.And the secondary organizing pneumonia was excluded.The clinical features,risk factor,therapy,and prognosis of COP were retrospectively reviewed.Results There were ten men and eight women,with a mean age of （59 ± 11）years.The main presentions were cough,sputum,and dyspnea.Lots of differences were existed in the presentation of the image.Fourteen patients were cured,however,four of them were relapsed.The effect of corticosteroid was good.Conclusions The clinical manifestation of COP has no specificity,thus it could be easily misdiagnosed.The clinical-radiological-pathological characteristic is contributed to the diagnosis of COP.The pathological evidences can earlier guide the diagnose and treatment.However,the prognosis of COP is well.