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目的探讨儿童非特异性间质性肺炎的临床、影像和病理特点。方法回顾性分析8例病理确诊的非特异性间质性肺炎患儿的临床资料,总结临床、影像和病理特点。结果 8例均有咳嗽,5例有三凹征和低氧血症,3例杵状指(趾),3例可闻及肺内啰音。1例4岁患儿未行肺功能检查,3例为限制性通气功能障碍,4例为混合性通气障碍。8例肺部高分辨CT均显示磨玻璃影,5例以弥漫性的磨玻璃影为主,2例以网格影为主,1例以多发实变影为主;2例有牵拉性支气管扩张,1例有局限性囊泡影。5例肺组织病理为富细胞型,以肺泡间隔慢性炎症为主,有淋巴细胞和浆细胞浸润;3例为混合型,可见较多的纤维组织增生。结论非特异性间质性肺炎临床表现无特异性,诊断依赖于病理和排除继发因素,如结缔组织病、过敏性肺炎。糖皮质激素对富细胞型的非特异性间质性肺炎治疗效果较好,而对混合型的治疗效果差。
Objective To investigate the clinical, imaging and pathological features of nonspecific interstitial pneumonia in children. Methods The clinical data of 8 patients with nonspecific interstitial pneumonia diagnosed by pathology were retrospectively analyzed. Clinical, imaging and pathological features were summarized. Results 8 cases had cough, 5 cases had three concave signs and hypoxemia, 3 cases clubbing (toe), 3 cases can be heard and pulmonary rales. A case of 4-year-old children did not perform pulmonary function tests, 3 cases of restrictive ventilation dysfunction, 4 cases of mixed ventilation disorders. 8 cases of high resolution lung CT showed ground glass, 5 cases of diffuse ground glass, 2 cases of grid-based, 1 case of multiple real changes in the main; 2 cases of traction Bronchiectasis, a case of limiting vesicle shadow. Five cases of lung pathology of the rich cell type, with chronic inflammation of alveolar septa mainly lymphocytes and plasma cells infiltration; 3 were mixed type, showing more fibrous tissue hyperplasia. Conclusion The clinical manifestations of nonspecific interstitial pneumonia are nonspecific. The diagnosis depends on the pathology and the exclusion of secondary factors such as connective tissue disease and allergic pneumonia. Glucocorticoid treatment of non-specific cell-rich non-specific interstitial pneumonia is better, and poor treatment of mixed type.