Puksa S, Hutcheon M A, Hyland R H
Thorax. 1983 Feb;38(2):146-50. doi: 10.1136/thx.38.2.146.
In a retrospective study of thirty-one immunosuppressed patients with new pulmonary infiltrates transbronchial biopsy provided a specific diagnosis in 11 of the 31 (36%) patients. In a further five patients, whose biopsy showed non-specific interstitial pneumonitis, a specific diagnosis was established by other means. Overall a specific diagnosis was obtained in 52% of patients. Twelve patients were left with a diagnosis of non-specific interstitial pneumonitis. In three out of 31 (10%) patients insufficient tissue was obtained. The seven patients who had metastatic carcinoma of the lung did poorly. The nine with other specific diagnoses did better in that five of them were alive after more than 11 months of follow-up. Patients with non-specific pneumonitis did well; eight out of 12 (67%) were alive after an average follow-up of 13.4 months. In 27 of the 31 (87%) patients the procedure was felt to have influenced therapeutic decisions. This was true whether the biopsy yielded a specific or a non-specific diagnosis. In our series making a specific diagnosis did not improve the patients' survival. Those with non-specific pneumonitis who were treated empirically did well, as did patients with specific diagnoses other than metastatic carcinoma of the lung.
在一项对31例新发肺部浸润的免疫抑制患者的回顾性研究中，经支气管活检为31例患者中的11例（36%）提供了明确诊断。另外5例活检显示为非特异性间质性肺炎的患者，通过其他方法确立了明确诊断。总体而言，52%的患者获得了明确诊断。12例患者被诊断为非特异性间质性肺炎。31例患者中有3例（10%）获取的组织不足。7例患有肺转移癌的患者情况较差。9例有其他明确诊断的患者情况较好，其中5例在随访超过11个月后仍存活。患有非特异性肺炎的患者情况良好；12例中有8例（67%）在平均随访13.4个月后仍存活。31例患者中有27例（87%）认为该操作影响了治疗决策。无论活检得出的是明确诊断还是非特异性诊断，都是如此。在我们的系列研究中，做出明确诊断并未提高患者的生存率。经验性治疗的非特异性肺炎患者情况良好，肺部转移癌以外有明确诊断的患者也是如此。
