Boots R J, McEvoy J D, Mowat P, Le Fevre I
Department of Anaesthesia and Intensive Care, Royal Brisbane Hospital, Qld.
Aust N Z J Med. 1995 Apr;25(2):140-5. doi: 10.1111/j.1445-5994.1995.tb02826.x.
The clinical presentation, course, and radiological spectrum of bronchiolitis obliterans organising pneumonia (BOOP) is still being characterised to aid differentiation from other causes of organising pneumonia.
To define the clinical presentation, response to therapy, and radiological spectrum of BOOP.
Fifteen cases of BOOP were retrospectively reviewed. The clinical presenting features, treatment and outcome of each patient were determined. Three independent readers and chest X-rays (CXRs) were blinded. CXRs were scored by a semi-quantitative method. Modal scores were calculated for type and profusion of opacification of each CXR.
The mean age of presentation was 64 years and the median duration of follow-up was 12.5 months. Thirteen patients received corticosteroid therapy. Outcome was varied. One patient had progressive loss of lung function, five had persisting symptoms with stable abnormal lung function, and nine were asymptomatic with near normal lung function. Five patients had a disease relapse. Symptoms length prior to presentation, duration and intensity of treatment were not associated with outcome (p = 0.23-0.9). Radiological opacities were alveolar in 73%, large localised infiltrates in 13%, nodular in 20% and mobile in 33% of CXR series. There was no relationship between overall profusion, type of CXR opacities and patient outcome, treatment duration or treatment intensity (p = 0.42-1.0).
The clinical spectrum of BOOP includes mild subacute, chronic progressive, and acute life threatening illness. Prognosis and response to treatment is variable. The diversity of radiological findings and clinical presentations should prompt consideration of the diagnosis in patients with undiagnosed respiratory tract symptoms and persisting or varying radiological abnormalities.
闭塞性细支气管炎伴机化性肺炎（BOOP）的临床表现、病程及影像学特征仍有待明确，以助于与其他机化性肺炎病因相鉴别。
明确BOOP的临床表现、对治疗的反应及影像学特征。
对15例BOOP病例进行回顾性分析。确定每位患者的临床特征、治疗及转归情况。3名独立阅片者对胸部X线片（CXR）进行盲法阅片。采用半定量方法对CXR进行评分。计算每个CXR的不透明度类型和密度的模式评分。
发病时的平均年龄为64岁，中位随访时间为12.5个月。13例患者接受了皮质类固醇治疗。转归各异。1例患者肺功能进行性下降，5例患者症状持续存在且肺功能异常稳定，9例患者无症状且肺功能接近正常。5例患者疾病复发。发病前症状持续时间、治疗时间及强度与转归无关（p = 0.23 - 0.9）。在CXR系列中，73%的影像学不透明度为肺泡性，13%为大片局限性浸润，20%为结节性，33%为游走性。总体密度、CXR不透明度类型与患者转归、治疗时间或治疗强度之间无相关性（p = 0.42 - 1.0）。
BOOP的临床谱包括轻度亚急性、慢性进行性和急性危及生命的疾病。预后和对治疗的反应各不相同。影像学表现和临床表现的多样性应促使对有未确诊呼吸道症状且存在持续或变化的影像学异常的患者考虑该诊断。
