中国呼吸与危重监护杂志

中国呼吸与危重监护杂志

髓过氧化物酶阳性间质性肺炎胸部 CT 研究

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目的 探讨髓过氧化物酶阳性间质性肺炎(interstitial pneumonia with positive myeloperoxidase antineutrophil cytoplasmic antibody,MPO-IP)的胸部高分辨率 CT 特点。 方法 回顾分析 MPO-IP 患者胸部高分辨率 CT 纤维化和肺气肿程度,并与同期收治的特发性肺纤维化(idiopathic pulmonary fibrosis,IPF)病例作比较。 结果 2014 年 7 月至 2016 年 3 月期间,各有 10 例患者分别被诊断为 MPO-IP 和 IPF, 两组间肺气肿无明显差异。MPO-IP 患者中 8 例影像学表现为普通性间质性肺炎(usual interstitial pneumonia,UIP),与 IPF 组比较,在气管分叉层面存在显著差异,肺纤维化评分低于 IPF患者。 结论 MPO-IP 影像学上以 UIP 为主,MPO-IP(UIP)纤维化程度较 IPF 轻,肺气肿以间隔旁肺气肿和小叶中心型肺气肿为主。

Objective To investigate the characteristics on chest high-resolution computed tomography (HRCT) of patients with interstitial pneumonia with positive myeloperoxidase antineutrophil cytoplasmic antibody (MPO-IP). Methods The extent of fibrosis and subtypes of emphysema on HRCT of MPO-IP patients were retrospectively analyzed and compared with idiopathic pulmonary fibrosis (IPF) cases admitted in the same period. Results From July 2014 to March 2016, 10 patients was diagnosed with IPF and 10 patients was diagnosed with MPO-IP. Emphysema was not different between two groups. Among the MPO-IP patients, 8 patients presented with a usual interstitial pneumonia (UIP) pattern. There existed statistical difference in the bronchial bifurcation level, the fibrosis score of lungs in the MPO-IP patients presented with UIP was lower than that in the IPF patients. Conclusions UIP is the predominant radiologic type of MPO-IP patients. Fibrosis in IPF is more serious than that in MPO-IP with UIP. Paraseptal and centrilobular emphysema are main forms in MPO-IP patients.

关键词: 间质性肺疾病; MPO 阳性; 特发性肺纤维化; 肺气肿; 高分辨率 CT

Key words: Interstitial pneumonia; Positive myeloperoxidase antineutrophil cytoplasmic antibody; Idiopathic pulmonary fibrosis; Emphysema; Chest high-resolution computed tomography

引用本文: 李学任, 刘斌, 丁梦江, 彭守春, 魏路清. 髓过氧化物酶阳性间质性肺炎胸部 CT 研究. 中国呼吸与危重监护杂志, 2018, 17(2): 183-186. doi: 10.7507/1671-6205.201611025 复制

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