摘要
目的 汇总分析20年来国内报道的肺泡蛋白沉积症（PAP）的临床特点、影像学特点、确诊方法、误诊情况、治疗及预后，为临床医师快速准确地诊断本病提供重要线索。方法回顾性分析1988—2008年国内有关肺泡蛋白沉积症的文献资料，总结126例肺泡蛋白沉积症误诊患者的临床资料。结果126患者误诊为肺炎19例，肺癌24例，支气管肺炎18例，特发性肺间质纤维化（IPF）19例，肺结核15例，嗜酸性肺炎10例，结节病9例，真菌肺炎7例，上呼吸道感染5例。肺泡蛋白沉积症患者的临床表现缺乏特异性，而影像学表现又呈多样性，临床易误诊，确诊有赖于肺泡灌洗液、肺活检以及病理学检查。结论肺泡蛋白沉积症临床表现缺乏特异性，极易导致误诊；全肺灌洗是肺泡蛋白沉积症最安全和有效的治疗方法。
Objective To analyze the epidemiology, clinieal and imageologlcal eharaeteristies, diagnosis, misdiagnosis, treatment and prognosis of pulmonary alveolar proteinosis （PAP） reported in China in recent 20 years, in an attempt to provide important clues for prompt and accurate diagnosis of PAP. Methods Clinical data of PAP from 1988 to 2008 in China were retrospectively analyzed and the clinical data of 126 patients with PAP which were misdiagnozed were summarized. Results There were 19 cases misdiagnozed with pneumonia,24 cases with pulmo- nary cancer, 18 cases with bronchitis, 19 cases with idiopathic pulmonary fibrosis, 15 cases with pulmonary tuberculosis, 10 cases with eosinophilic pneumonia,9 cases with sarcoidosis ,5 cases with fungus pneumonia. The clinical manifestations of PAP had no specificity and the imageology manifestation was various. Its final diagnosis mainly depended on the examination of brochoalveolar lavage fluid and/or lung biopsy, and pathologic examination. Conclusions The diversity of clinical manifestations of PAP has resulted in higher clinical misdiagnosis rate. Whole lung irriga- tion is the safest and the most effective way to treat PAP.
出处
《中国综合临床》
2009年第12期1276-1278,共3页
Clinical Medicine of China
关键词
肺泡蛋白沉积症
支气管肺泡灌洗
误诊
Pulmonary alveolar proteinosis
Lung irrigation
Misdiagnosis
