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90例嗜酸性粒细胞增多症合并外周血嗜酸性粒细胞增多性肺浸润的临床分析

[Clinical analysis of 90 cases of eosinophilia and pulmonary infiltrates with peripheral eosinophilia].

作者信息

Li L Y, Xue C S, Luo W C

机构信息

Department of Internal Medicine, PUMC Hospital, Beijing.

出版信息

Zhonghua Nei Ke Za Zhi. 1990 Nov;29(11):659-62, 702.

PMID:2086006
Abstract

90 patients diagnosed as eosinophilia and pulmonary infiltrates with peripheral eosinophilia in PUMC Hospital from 1957 to 1986 were reported. The cause of the eosinophilia was unknown in 42% of the patients. Among these patients, hypereosinophilic syndromes (HES) were suspected in 11 patients. The most common presenting symptoms of HES were fever, skin lesions gastrointestinal symptoms and hepatosplenomegaly, the mean peripheral blood eosinophil count was as high as 25.6 x 10(9) cells/L. Biopsies of bone marrow and involved organs revealed extensive eosinophilic infiltration and severe necrosis. In the past ten years, eosinophilia and pulmonary infiltrates caused by parasitic infections obviously decreased. The most common parasites were ascaris Lumbricoides, Ancylostoma duodenale and Clonorchis sinesis. The other main causes which induced pulmonary infiltrates were allergic bronchopulmonary mycosis (ABPM) and chronic eosinophilic pneumonia. The prevalence of ABPM increased recently; early diagnosis and effective therapy could prevent the irreversible damage resulting in airways obstruction and fibrosis.

摘要

报告了1957年至1986年期间在北京协和医院诊断为嗜酸性粒细胞增多症和肺部浸润伴外周血嗜酸性粒细胞增多的90例患者。42%的患者嗜酸性粒细胞增多的原因不明。在这些患者中,11例疑似高嗜酸性粒细胞综合征(HES)。HES最常见的症状为发热、皮肤病变、胃肠道症状和肝脾肿大,外周血嗜酸性粒细胞平均计数高达25.6×10⁹/L。骨髓和受累器官活检显示广泛的嗜酸性粒细胞浸润和严重坏死。在过去十年中,由寄生虫感染引起的嗜酸性粒细胞增多症和肺部浸润明显减少。最常见的寄生虫为蛔虫、十二指肠钩虫和华支睾吸虫。引起肺部浸润的其他主要原因是变应性支气管肺曲霉病(ABPM)和慢性嗜酸性粒细胞性肺炎。ABPM的患病率最近有所增加;早期诊断和有效治疗可预防导致气道阻塞和纤维化的不可逆损害。

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