非特异性间质性肺炎7例临床分析

Nonspecific interstitial pneumonia: A clinical analysis of 7 cases

  • 摘要: 目的 探讨非特异性间质性肺炎(nonspecific interstitial pneumonia,NSIP)的临床特点及治疗效果,以提高临床诊治水平。 方法 回顾性分析解放军总医院2007年3月-2012年6月经病理确诊的7例NSIP住院患者的临床、影像学、病理学及治疗资料。 结果 女4例,男3例,平均年龄(49.1±17.3)岁。临床表现主要为咳嗽、呼吸困难及双下肺爆裂音。胸部CT主要表现双下肺磨玻璃影、实变影及网状阴影。7例均接受肺活检,其中3例为富细胞型,3例纤维化型,1例混合型。6例接受肺功能检查均存在限制性肺通气功能障碍伴弥散功能下降,3例合并小气道功能障碍。7例平均动脉血氧分压为(72.3±11.8) mmHg(1 mmHg=0.133 kPa)。6例给予全身糖皮质激素治疗。随访5例,3例病理表现富细胞型激素治疗效果好,2例病理表现纤维化型激素疗效欠佳。 结论 NSIP诊断应结合临床、影像学和病理学等多学科结果分析得出。激素疗效与组织病理类型相关,富细胞型效果好,纤维化型效果差。

     

    Abstract: Objective To improve the clinical diagnosis and treatment of nonspecific interstitial pneumonia(NSIP) by studying its clinical characteristics and response to treatment. Methods Clinical data, including presentations, Chest CT scan findings, pathological examination and treatment, about 7 patients with pathology-proved NSIP admitted to our hospital from March 2007 to June 2012 were retrospectively reviewed. Results Of the 7 patients, 4 were females and 3 males with mean age of 49.1±17.3 years. They were mainly manifested as cough, dyspnea and velcro in both lower lungs. Chest CT scan revealed a bilateralpredominant process with patchy areas of ground-glass opacity, consolidation and reticular abnormality. Of the 7 patients who underwent lung biopsy, 3 were diagnosed with cellular NSIP, 3 with fibrotic NSIP and 1 with mixed NSIP. Lung function test showed restrictive ventilation dysfunction with diffusing capacity declined in 6 patients. Of these 6 patients, 3 were complicated by small airway dysfunction. The average PaO2 of the 7 patients was 72.3±11.8 mmHg. Of the 6 patients who were treated with systemic corticosteroids, 5 were followed up, during which 3 with cellular NSIP had a good response to corticosteroid therapy and 2 with fibrotic NSIP had a poor response to corticosteroid therapy. Conclusion NSIP should be diagnosed according to its clinical manifestations, radiological and pathological examination. The effect of corticosteroid therapy on it depends on its pathological type and is good for cellular NSIP and poor for fibrotic NSIP.

     

/

返回文章
返回