隐源性和继发性机化性肺炎诊断的研究进展

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摘要

机化性肺炎（OP）是一种以远端气腔内炎性纤维栓的存在为主要病理表现的肺部病变，根据病因分为隐源性机化性肺炎（COP）和继发性机化性肺炎（SOP）。基于COP 和SOP 在治疗与管理方面的差异性，二者的尽早诊断极其重要。OP 包括损伤、机化、重建的过程，COP 的病因未知，SOP 的病因包括药物、感染、结缔组织病等。COP和SOP 在临床表现方面无特异性，溯因性的实验室检查对于SOP 查找病因具有重要参考价值。二者典型的CT表现是多灶性实变，非典型表现呈现多样性，需要注意与其他疾病的鉴别诊断。组织病理学是OP 诊断的主要标准，包括经典型和特殊类型（急性纤维素性OP 和瘢痕型OP），其特征可与影像学模式相对应，且为SOP 病因查找提供线索。多学科团队对于临床、实验室检查、影像及病理信息的综合分析，对于COP 和SOP 的诊断与管理极其重要。

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关键词 ：机化性肺炎, 隐源性, 继发性, 间质性肺病, 诊断

Abstract：

Organizing pneumonia (OP)is a kind of lung disease with the presence of inflammatory fibrous thrombus in the distal air cavity as the main pathological manifestation.According to etiology,OP can be divided into cryptogenic organizing pneumonia(COP)and secondary organizing pneumonia(SOP).In view of the differences between COP and SOP in treatment and management,early diagnosis of them is extremely important.OP includes the process of injury,organization and reconstruction.The cause of COP is still unknown.The causes of SOP include drugs,infection,connective tissue diseases and so on.COP and SOP are not specific in clinical manifestations,and retrospective laboratory examination is of great reference value for SOP to inquire about the cause.The typical CT manifestations are multifocal consolidation,and the atypical manifestations are diverse,so it is necessary to pay attention to the differential diagnosis of other diseases.Pathohistology is the main criterion for the diagnosis of OP,including classical and special types (acute fibrinous OP and cicatricial OP),and its characteristics can correspond to the imaging mode and provide clues for the inquiry of the cause of SOP.It is very important for the diagnosis and management of COP and SOP that multidisciplinary teams synthesize clinical,laboratory,imaging and pathological information.

Key words： Organizing pneumonia Cryptogenic Secondary Interstitial lung diseases Diagnosis

基金资助:宁夏回族自治区重点研发计划项目（2023BEG02 023）。

引用本文:

刘梓瑾；曹霞；庞玉；张正平；黄凌燕. 隐源性和继发性机化性肺炎诊断的研究进展[J]. 中国当代医药, 2024, 31(14): 176-181.
LIU Zijin1 CAO Xia2 PANG Yu3 ZHANG Zhengping4 HUANG Lingyan5. Research progress in diagnosis of cryptogenic and secondary organizing pneumonia. 中国当代医药, 2024, 31(14): 176-181.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2024/V31/I14/176

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