嗜酸性肺疾病33例临床分析

B. Tu
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摘要

目的总结嗜酸性肺疾病(ELD)的诊治经验,提高该病的诊治水平。方法回顾性分析2016年1月至2019年1月在郑州大学第一附属医院确诊并住院的33例ELD患者的病史、病程、临床表现、实验室检查、影像学检查、病理结果、诊疗及预后。结果33例ELD患者中,男性19例,女性14例,平均年龄(41.30±14.26)岁。33例ELD患者中过敏性支气管肺曲霉病(ABPA) 20例,慢性嗜酸性肺炎(CEP) 8例,嗜酸性肉芽肿性多血管炎(EGPA) 5例。33例患者均行外周血检测,27例患者外周血嗜酸性粒细胞(EOS)升高。28例患者行血清总免疫球蛋白E(IgE)测定,其中25例患者血清总IgE升高。26例患者行肺功能检查,其中18例有肺功能障碍,8例有弥漫性功能障碍。胸部ct主要表现为肺部浸润,肺内可见斑片状、条状、团块状、磨玻璃样高密度影。肺组织病理检查示嗜酸性粒细胞浸润。糖皮质激素单独或与其他药物联合治疗ELD是有效的。结论ELD临床表现多样,易误诊。其诊断主要依靠临床表现、实验室检查、影像学检查。必要时应行肺组织病理学检查诊断。糖皮质激素是治疗ELD的基础药物。关键词:嗜酸性粒细胞肺病;嗜酸性粒细胞;肺组织活检;糖皮质激素
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical analysis on 33 cases of eosinophilic pulmonary disease
Objective To summarize the experience of diagnosis and treatment of eosinophilic lung disease (ELD), and to improve the diagnosis and treatment of such diseases. Methods Retrospective analysis was performed on clinical data from 33 patients with ELD diagnosed and hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2016 to January 2019, including medical history, course of disease, clinical manifestations, laboratory examination, imaging examination, and pathological results, diagnosis and treatment and prognosis. Results Among the 33 patients with ELD, 19 patients were males and 14 patients were females, with an average age of (41.30±14.26)years. There were 20 cases of allergic bronchopulmonary aspergillosis (ABPA), 8 cases of chronic eosinophilic pneumonia (CEP), and 5 cases of eosinophilic granulomatous polyangiitis (EGPA) among the 33 ELD patients. Thirty-three patients all underwent peripheral blood determination, and peripheral blood eosinophils (EOS) increased in 27 patients. Twenty-eight patients underwent serum total immunoglobulin E(IgE) determination, and 25 patients of them had elevated serum total IgE. Twenty-six patients underwent pulmonary function tests, and 18 of them had pulmonary dysfunction, and 8 patients had diffuse dysfunction. Thoracic computed tomography showed mainly infiltration in the lungs, with patchy, strip-like, clump-like, and ground-glass-like high-density shadows in the lungs. Pathological examination of lung tissue showed eosinophil infiltration. Glucocorticoid alone or in combination with other drugs is effective in the treatment of ELD. Conclusions ELD has a variety of clinical manifestations, for which resaon the disease could be misdiagnosed easily. Its diagnosis mainly depends on clinical manifestations, laboratory tests, imaging examinations. And lung histopathology should be performed for diagnosis if necessary. Glucocorticoid is the basic drug for ELD treatment. Key words: Eosinophilic lung disease; Eosinophil; Lung tissue biopsy; Glucocorticoid
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