82例弥漫性肺浸润病例的临床分析余纪会敖敏郭述良400016重庆.docVIP

82例弥漫性肺浸润病例的临床分析 余纪会 敖敏 郭述良（400016 重庆，重庆医科大学附属第一医院呼吸科） 【摘要】目的 分析、总结弥漫性肺浸润（diffuse pulmonary infiltrates ,DPI）的病因构成、临床特点、胸部影像学特点、鉴别诊断要点、实验室检查要点，以提高临床医师对DPI的认识和诊治水平。方法 前瞻性研究我院2010年3月-2011年7月诊治的82例DPI患者的临床资料。结果 82例DPI患者的病因构成如下：感染性疾病30例(36.6%)，特发性间质性肺炎（idiopathic interstitial pneumonia ,IIP）17例(20.7%)，结缔组织疾病(connective tissue disease ,CTD)肺部浸润9例(11%)，肺癌6例(7.3%)，血管炎4例(4.9%)，肺水肿4例(4.9%)，结节病3例(3.7%)，肺泡蛋白沉着症(pulmonary alveolar proteinosis ,PAP)2例(2.4%)，淋巴瘤、肺泡微石症、放射性肺炎、吸入性肺炎、药物因素致肺纤维化、弥漫性泛细支气管炎（diffuse panbronchiolitis ,DPB）、特发性肺含铁血黄素沉着症各1例(1.2%)。不同病因的DPI在临床病史、体征、胸部影像学、实验室检查及肺活检病理学检查等方面都有各自的特点。结论 部分DPI患者依靠临床特点、实验室检查、胸部影像学特点尤其是胸部HRCT可确诊，不能确诊者应尽早作肺活检明确诊断。 【关键词】弥漫性肺浸润；临床；影像学；病因；鉴别诊断 Clinical analysis of 82 patients with diffuse pulmonary infiltrates Yu Jihui, Ao Min, Guo Shuliang（Department of Respiratory, First Affiliated Hospital, Chongqing Medical University, Chongqing , 400016, China）【Abstract】　Objective To study and summarize the cause constitution, clinical feature, chest radiograph feature, differential diagnosis Point and Laboratory points of diffuse pulmonary infiltrates （DPI）, So as to improve the clinicians understanding of the DPI and the level of diagnosis and treatment. Methods The clinical data of 82 cases who were diagnosed as DPI in our hospital from Mar 2010 to Jul 2011 were studied Prospectively. Results The cause constitutions of 82 DPI patients were infectious disease 30 cases(36.6%), idiopathic interstitial pneumonia (IIP) 17 cases (20.7%), connective tissue disease (CTD) pulmonary infiltrates 9 cases (11%), lung cancer 6 cases (7.3%), vasculitis 4 cases (4.9%), pulmonary edema 4 cases (4.9%), sarcoidosis 3 cases (3.7%), pulmonary alveolar proteinosis (PAP) 2 cases (2.4%), lymphoma, alveolar microlithiasis, radiation pneumonitis, aspiration pneumonia,drug-induced pulmonary fibrosis factors, diffuse panbronchiolitis (DPB), idiopathic pulmonary hemosiderosis syndrome was 1 case (1.2%) respectively. Different causes of DPI in clinical history, signs, h