Dept of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul, Korea.
Eur Respir J. 2013 Feb;41(2):402-9. doi: 10.1183/09031936.00221811. Epub 2012 May 17.
The clinical characteristics and optimal duration of corticosteroid treatment for acute eosinophilic pneumonia (AEP) have not been fully evaluated. This was a retrospective study of prospectively collected data from 137 patients with AEP, treated with standardised protocol, to clarify the clinical characteristics and compare the efficacies of 2 weeks versus 4 weeks of corticosteroid treatment for AEP. The majority of the patients altered their smoking habits within a median (interquartile range) of 17 (13-26) days prior to development of AEP. 80 (58%) patients presented with acute respiratory failure. A total of 127 (92%) patients were treated with corticosteroids: 4 weeks, n=42; 2 weeks, n=85. Major symptoms were resolved in 3 days and the severity of respiratory failure was inversely correlated with clinical outcomes. After adjusting for differences in baseline characteristics between the groups, the differences in adjusted mean (95% confidence interval) for resolution of dyspnoea and disappearance of all symptoms were 0.57 (-0.71-1.86) and -0.04 (-1.91-1.83) days, respectively. The difference in adjusted proportion of resolution of radiological abnormalities was 6.92% (-8.19-22.02). In conclusion, the duration of corticosteroid treatment could be shortened to 2 weeks, even in patients with respiratory failure.
急性嗜酸性粒细胞肺炎（AEP）的临床特征和皮质类固醇治疗的最佳持续时间尚未得到充分评估。这是一项回顾性研究，对接受标准化方案治疗的 137 例 AEP 患者的前瞻性收集数据进行了分析，旨在阐明其临床特征，并比较 2 周与 4 周皮质类固醇治疗 AEP 的疗效。大多数患者在 AEP 发作前的中位数（四分位间距）17（13-26）天内改变了吸烟习惯。80（58%）例患者出现急性呼吸衰竭。共有 127（92%）例患者接受皮质类固醇治疗：4 周，n=42；2 周，n=85。主要症状在 3 天内缓解，呼吸衰竭的严重程度与临床结局呈负相关。在校正组间基线特征差异后，呼吸困难缓解和所有症状消失的调整后平均差异（95%置信区间）分别为 0.57（-0.71-1.86）和-0.04（-1.91-1.83）天。影像学异常缓解的调整比例差异为 6.92%（-8.19-22.02）。总之，即使在呼吸衰竭患者中，皮质类固醇治疗的持续时间也可以缩短至 2 周。
