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婴儿期神经内分泌细胞增生症患者的临床、功能和计算机断层扫描表现。

Clinical, functional, and computed tomography findings in a cohort of patients with neuroendocrine cell hyperplasia of infancy.

机构信息

Department of Medicine, Respiratory Center, Ricardo Gutierrez Children's Hospital, Buenos Aires, Argentina.

Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.

出版信息

Pediatr Pulmonol. 2021 Jun;56(6):1681-1686. doi: 10.1002/ppul.25319. Epub 2021 Feb 23.

Abstract

INTRODUCTION

Neuroendocrine cell hyperplasia of infancy (NEHI) is one of the most common interstitial lung diseases in children. Both the etiology and pathophysiological mechanisms of the disease are still unknown. Prognosis is usually favorable; however, there are significant morbidities during the early years of life.

OBJECTIVE

To describe the clinical course, infant pulmonary function tests and computed tomography (CT) findings in a cohort of patients with NEHI in Argentina.

METHODS

This is a observational multicenter cohort study of children diagnosed with NEHI between 2011 and 2020.

RESULTS

Twenty patients participated in this study. The median age of onset of symptoms was 3 months and the median age at diagnosis was 6 months. The most common clinical presentation was tachypnea, retractions and hypoxemia. The chest CT findings showed central ground glass opacities and air trapping. Infant pulmonary function tests revealed an obstructive pattern in 75% of the cases (10/12). Most patients (75%) required home oxygen therapy for 17 months (interquartile range 12-25). In 85% of them, tachypnea and hypoxemia spontaneously resolved between the second and third years of life.

CONCLUSION

In this cohort, the first symptoms appeared during the early months of life. The typical clinical, CT, and functional findings allowed the diagnosis without the need of a lung biopsy. Although most patients required home oxygen therapy, they showed a favorable evolution.

摘要

介绍

婴儿期神经内分泌细胞增生症(NEHI)是儿童中最常见的间质性肺疾病之一。该疾病的病因和病理生理机制尚不清楚。预后通常良好;然而,在生命的早期有显著的发病率。

目的

描述在阿根廷的一组 NEHI 患者的临床过程、婴儿肺功能测试和计算机断层扫描(CT)结果。

方法

这是一项针对 2011 年至 2020 年间诊断为 NEHI 的儿童的观察性多中心队列研究。

结果

共有 20 名患者参与了这项研究。症状发作的中位年龄为 3 个月,诊断时的中位年龄为 6 个月。最常见的临床表现是呼吸急促、肋间隙凹陷和低氧血症。胸部 CT 结果显示中央磨玻璃影和空气滞留。婴儿肺功能测试显示 75%的病例(10/12)存在阻塞模式。大多数患者(75%)需要家庭氧疗 17 个月(四分位距 12-25)。在他们中,85%的患者在 2-3 岁之间呼吸急促和低氧血症自发缓解。

结论

在本队列中,最初的症状出现在生命的早期。典型的临床、CT 和功能发现可无需肺活检即可做出诊断。尽管大多数患者需要家庭氧疗,但他们的预后良好。

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