对于急性狼疮性肺炎临床分析.docVIP

对于急性狼疮性肺炎临床分析 　　摘要：目的对治疗急性狼疮性肺炎进行观察和分析。方法30例急性狼疮性肺炎的患者作为研究对象，均注射加入1.0 g甲强龙的5%葡萄糖生理盐水0.5 L点滴，连续3 d，1次/d，观察病情，从第4 d开始注射加0.9 g环磷酰胺的生理盐水0.2 L点滴，每隔3~4 w根据患者病情进行环磷酰胺冲击1次，到第5 d，让患者服用于强的松50 g/d，若发现患者出现合并性感染，可外加广谱抗生素。结果30例患者经过数周治疗后，10例患者病情恢复健康；16例患者病情肺部弥漫性斑状阴影消散，病情明显好转；其余4例因通气功能障碍导致呼吸衰竭而死亡。结论联合应用同作为免疫抑制剂的环磷酰胺和甲强龙治疗急性狼疮性肺炎患者不仅疗效快而且副作用小，可以在临床实践中推广使用。 　　关键词：急性肺炎；狼疮性肺炎；治疗急性肺炎 　　Clinical Analysis of Acute Lupus Pneumonia 　　YANG Xiao-shan 　　(Binzhou City Peoples Hospital, Binzhou 256610,Shandong,China) 　　Abstract：ObjectiveTo treat acute lupus pneumonitis were observed and analyzed. MethodsTo our hospital 30 cases of patients with acute lupus pneumonia patients as the research object, were injected into 1.0g methylprednisolone five percent glucose in normal saline 0.5L intravenous drip, observation for three consecutive days, once a day, fourth days from the start of cyclophosphamide injection plus 0.9g physiological saline 0.2L dropping, enjoin patient drinking lots of water, every three to four weeks according to patients condition of cyclophosphamide pulse at a time, until the fifth day, let patients in prednisone 50g/d, if it is found that the patients with infection, antibiotics can be applied. Results30 patients after several weeks after the treatment, 10 cases of patients recovered; 16 cases of patients with pulmonary diffuse patchy shadow dissipation, condition improved markedly; the remaining 4 patients with ventilation dysfunction leading to respiratory failure and death. ConclusionThe combined application of the same as immunosuppressant cyclophosphamide and methylprednisolone treatment in patients with acute lupus pneumonia is not only quick curative effect and little side effect, can be widely used in clinical practice. 　　Key words：Acute lupus pneumonia; Pneumonia; Treatment of acute pneumonia 　　CTX冲击治疗简称ALP，是一种系统性红斑狼疮引起肺部的非感染性急性炎症症状，属于自身性免疫系统缺陷的一种疾病。系统性红斑狼疮可损害多处内脏，造成急性狼疮性肺炎并不常见，其病因可能是肺部沉淀过多抗原抗体所致。患者临床表现多为呼吸困难、胸闷痛、干咳甚至咳血、发烧，经检验可听到双肺底可闻及湿性罗音。经过CT和X线胸片检测，双肺或单肺在肺可见明显的弥漫性