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中国防痨杂志 ›› 2006, Vol. 28 ›› Issue (3): 145-147.

• 论著 • 上一篇    下一篇

14例肺嗜酸细胞增多症误诊肺结核原因分析

蒋瑞华   

  1. 上海市肺科医院结核科 上海 200433
  • 出版日期:2006-03-10 发布日期:2006-11-03

The analysis of misdiagnosis pulmonary eosinophilia as tuberculosis:14 cases report

Jiang Ruihua   

  1. Tuberculosis Department of Shanghai Pulmonary Hospital,Shanghai200443,China
  • Online:2006-03-10 Published:2006-11-03

摘要: 目的通过对肺嗜酸细胞增多症误诊为肺结核的原因分析,提高对两种疾病的鉴别诊断能力。方法对14例经临床及实验室检查证实的肺嗜酸细胞增多症误诊肺结核的原因进行回顾性分析。结果误诊肺结核的肺嗜酸细胞增多症患者最常见的症状为咳嗽、咳黏痰、胸痛及低热、乏力、盗汗等全身中毒症状,病程常超过3周。胸部X线、CT表现多种多样。“Y”字形或葡萄状阴影,阻塞部位远端可有肺不张或阻塞性炎症。结论痰结核菌阴性而临床症状和X线表现与肺结核相似,经正规抗结核治疗后仍反复发作或无效的病人,应考虑到肺嗜酸细胞增多症。

关键词: 肺嗜酸细胞增多症, 误诊, 结核,肺

Abstract: Objective To improve differential diagnosis ability of pulmonary eosinophilia and pulmonary tu-berculosis through analyzing the reason of misdiagnosis between pulmonary eosinophilia and pulmonary tuberculosis.Methods 14 pulmonary eosinophilia cases which were confirmed by clinical and lab test and were misdiagnosed as pulmonary tuberculosis were analyzed retrospectively. Results The symptoms of pulmonary eosinophilia misdiagnoses as pulmonary tuberculosis including coughing, mild phlegm, chest pain, breathlessness, dyspnea, low-grade fever, hypodynamia and night sweat. The duration of the disease was more than three weeks. The thoracic X-ray and CT manifestations were multifarious: the special manifestations were“Y”or botryoidalis shadows, pul- monary atelectasis and obstructive pneumonia changes in the distal obstructive location. Conclusion The reason of misdiagonosis is lack of knowledge of pulmonary eosinophilia. We should be alert to pulmonary eosinophilia that sputum examination is negative, clinical symptom and chest X-ray examination is similar as tuberculosis, but relapses or has no effect after regular therapy.

Key words: Pulmonary eosinophilia, Misdiagnosis, Pulmonary tuberculosis