摘要
目的探讨累及肺脏克罗恩病的临床表现。方法对我院收治1例临床确诊累及肺脏克罗恩病患者的临床资料进行分析，并结合文献进行复习。结果患者临床表现为咳嗽、咳痰、发热，胸部CT示双肺斑片状阴影，病原学检查阴性，抗菌治疗2个月双肺阴影无明显变化，纤维支气管镜示气管及右上叶开口处结节状新生物，病理示肉芽组织息肉状增生，给予泼尼松和柳氮磺胺吡啶治疗半个月后双肺阴影明显消散，气管内结节消失，右上叶开口处结节明显缩小。检测到以英文发表的相关文献，病理确诊的克罗恩病累及肺脏或合并肺部并发症病例共34例。克罗恩病累及肺脏罕见，以咳嗽、咳痰、发热为常见临床表现，肺脏和肠道常有相同病变理变化，即肉芽肿性炎症。对糖皮质激素反应良好，可应用糖皮质激素加柳氮磺胺吡啶治疗。结论克罗恩病出现呼吸道症状时应考虑累及肺脏的可能，结合临床和病理可以确诊。
Objective To describe the characteristics of pulmonary involvement in Crohn disease. Methods The clinical data of one patient with Crohn disease complicated with pulmonary involvement was described and relevant literature were reviewed. Results The patient showed chief complaints of cough, expectoration and fever. The chest CT scan revealed bilateral lung opacity shadows,Ziehl-Neelsen acid-fast stain examination in sputum and cultures got negative results for many times. Chest CT scan revealed no dissipation after different antimicrobials treatment for 2 months. The fiberoptic bronchoscopy was performed, which showed nodular lesions in the trachea and beside the opening of right upper lobe. Histopathology showed polypoid hyperplasia of granulation tissue. The bilateral patchy opacity dissipated, the nodes in the trachea disappeared and the nodes beside the opening of right upper lobe diminished obviously after the patient was treated with oral prednisone and salicylazosulfapyridine （SASP）. Pulmonary involvement in Crohn disease is very rare and it can involve any part of the lungs. The most common manifestations are cough, expectoration and fever. The lung and gastrointestinal system often share similar pathogenetic changes： granulomatous inflammation. These patients responded well to combination use of glucocorticoid and SASP. Conclusion Pulmonary involvement should be considered when patients with Crohn disease manifested with respiratory symptoms, which can be definitely diagnosed by clinical features and histopathological examintation.
出处
《中国综合临床》
2011年第8期822-826,共5页
Clinical Medicine of China
关键词
克罗恩病
肺疾病
柳氮磺胺吡啶
Crohn disease
Lung disease
Salicylazosulfapyridine
