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目的 探讨普通型间质性肺炎(UIP)的病理形态特点,以及开胸肺活组织检查的意义和适应证。方法 对5例UIP(尸解1例和肺活检4例)的HE及组织化学染色的病理形态、以及临床、影像学和预后的资料进行分析。结果 其病理表现有肺泡间质炎、成纤维细胞灶、间质纤维化和蜂窝肺,并伴细支气管上皮化生和Ⅱ型细胞增生,以及灶性肺泡内巨细胞聚集。上述改变为不均匀的分布。结论 UIP的病理特点为低倍镜下的形态不一致性,并且为新老病变共存。对于影像表现不典型和能耐受开胸手术的患者,开胸肺活组织检查的病理诊断是必要的。但UIP的病理诊断过程要密切结合临床和影像学的检查。
Objective To investigate the pathological features of common interstitial pneumonia (UIP) and the significance and indications of open lung biopsy. Methods The pathological changes of HE and histochemical staining in 5 cases of UIP (autopsy in 1 case and 4 cases of lung biopsy), as well as clinical, radiographic and prognostic data were analyzed. Results The pathological findings were alveolitis, fibroblastic foci, interstitial fibrosis and honeycomb lung, with bronchial epithelial metaplasia and type Ⅱ cell hyperplasia, and focal alveolar macrophages. The above changes are unevenly distributed. Conclusion The pathological features of UIP are morphological inconsistency under low magnification and coexistence of new and old lesions. Pathological diagnosis of open lung biopsy is necessary for patients with atypical and thoracic surgery. However, the pathological diagnosis of UIP should be closely combined with clinical and imaging studies.