Kobayashi H, Matsubara O, Kano S, Uwabe Y, Kikuma H, Morisako T, Aida S, Tamai S, Nagata N
Third Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Dec;34(12):1343-8.
Chronic eosinophilic pneumonia is characterized by infiltration of eosinophils into alveolar spaces. Patients with this condition may also have asthmatic episodes, chronic coughing, and bronchorrhea, even after the infiltrative opacity on the chest roentgenogram resolves. We used computed tomography, pulmonary function tests, and biopsies to evaluate the airways of 11 patients with chronic eosinophilic pneumonia. The tomograms showed bronchial wall thickening in all patients at the time of the onset of symptoms and ten months later. Centrilobular peribronchovascular interstitial thickening was detected in four patients, 10 months after the onset. Pulmonary function tests showed that small airway dysfunction remained 13 months after the onset. Pathological analysis revealed airway abnormalities that included basement membrane thickening and cellular infiltration 2 years after the onset. These results show that airway changes had not resolved even after roentgenographic opacities had disappeared. More attention should be given to treatment of airway disease associated with chronic eosinophilic pneumonia, and to whether these changes in the airway are similar to those seen in bronchiolitis obliterans organizing pneumonia.
慢性嗜酸性粒细胞性肺炎的特点是嗜酸性粒细胞浸润至肺泡腔。患有这种疾病的患者即使胸部X线片上的浸润性阴影消失后，仍可能出现哮喘发作、慢性咳嗽和支气管分泌增多。我们使用计算机断层扫描、肺功能测试和活检来评估11例慢性嗜酸性粒细胞性肺炎患者的气道。断层扫描显示，所有患者在症状发作时及10个月后均有支气管壁增厚。发病10个月后，4例患者检测到小叶中心支气管血管周围间质增厚。肺功能测试显示，发病13个月后仍存在小气道功能障碍。病理分析显示，发病2年后气道异常包括基底膜增厚和细胞浸润。这些结果表明，即使X线片上的阴影消失，气道改变仍未消退。应更加关注与慢性嗜酸性粒细胞性肺炎相关的气道疾病的治疗，以及这些气道改变是否与闭塞性细支气管炎机化性肺炎所见的改变相似。
