【摘要】：目的： 探討外源性過敏性肺泡炎(EAA)的臨床表現(xiàn)、影像學(xué)特點及診斷治療。 方法： 回顧分析2009年10月至2012年3月浙江大學(xué)醫(yī)學(xué)院附屬第一醫(yī)院呼吸科診斷為外源性過敏性肺泡炎的住院患者6例,總結(jié)其臨床表現(xiàn)、影像學(xué)特點、診斷及治療情況。 結(jié)果： 6例患者中4例有較明確的過敏原接觸環(huán)境。6例患者均因不同程度的臨床癥狀而就診,主要癥狀為咳嗽、咳痰、發(fā)熱和胸悶氣促。肺部CT表現(xiàn)多樣,有兩肺多發(fā)結(jié)節(jié)狀稍高密度影,兩肺彌漫性斑片狀或磨玻璃樣影,兩肺彌漫性粟粒灶,條索狀致密影等。其中4例有總IgE升高,2例IgA和IgG升高。5例患者確診或可疑EAA后使用糖皮質(zhì)激素治療,1例使用脫離接觸環(huán)境治療,6例患者均有臨床癥狀緩解或影像學(xué)上好轉(zhuǎn)。 結(jié)論： 外源性過敏性肺泡炎多有過敏原接觸史,臨床表現(xiàn)特異性低,影像學(xué)表現(xiàn)多樣。提高早期確診率、及時使用糖皮質(zhì)激素治療可以提高疾病預(yù)后。
[Abstract]:Objective: to investigate the clinical manifestations, imaging features and diagnosis and treatment of exogenous allergic alveolitis (EAA). Methods: from October 2009 to March 2012, 6 inpatients diagnosed as exogenous allergic alveolitis in the Department of Respiratory, first affiliated Hospital of Zhejiang University Medical College were retrospectively analyzed, and their clinical manifestations, imaging features, diagnosis and treatment were summarized. Results: 4 out of 6 patients had definite allergen contact environment, 6 patients were treated with different clinical symptoms, the main symptoms were cough, expectoration, fever and chest tightness. Pulmonary CT showed multiple nodular hyperdense shadows in both lungs, diffuse plaques or ground-glass shadows in both lungs, diffuse miliary foci in both lungs, and stripe dense shadows, and so on. Of them, 4 cases had elevated total IgE, 2 cases had increased IgA and IgG, 5 cases had been treated with glucocorticoid after diagnosed or suspected EAA, 1 case had been treated with disengagement environment, and 6 cases had clinical symptom relief or imaging improvement. Conclusion: exogenous allergic alveolitis has a history of exposure to allergens, with low specificity and multiple imaging manifestations. Early diagnosis and timely use of glucocorticoid can improve the prognosis of the disease.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R563.1

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