摘要过敏性肺炎是一种特殊的弥漫性肺实质疾病,因反复吸入致敏原如微生物、动植物蛋白、小分子有机物而致病.临床表现为急性起病或隐匿出现的咳嗽、气短,影像学呈现弥漫分布的磨玻璃影、小叶中心型微结节、气体陷闭、肺纤维化以及肺气肿等特点.肺泡灌洗液提示为淋巴细胞型肺泡炎、CD4/CD8下降,组织学表现为慢性炎细胞浸润的间质性肺炎及细支气管炎、形成不良的非坏死性肉芽肿.诊断依据暴露史、临床特点、影像学、血清学、肺泡灌洗液、组织学等特点共同决定.治疗上主要是避免接触致敏原以及使用全身糖皮质激素.预后相对较好.

abstractsHypersensitivity pneumonitis is a pulmonary disease with symptoms of cough and dyspnea resulting from the inhalation of an antigen to which the subject has been previously sensitized,such as microbes,animal or plant proteins and certain chemicals that form haptens.The radiologic findings include diffuse ground-glass opacification,small centrilobular nodules,air trapping,fibrosis and emphysema.Bronchoalveolar lavage fluid reveals a lymphocyte alveolitis with CD4/CD8 decrease.The histopathologic process consists of chronic inflammation of the bronchi and peribronchiolar tissue,often with poorly defined granulomas.The diagnosis usually rests on a variable combination of findings from history,clinical manifestation,radiography,serology,bronchoalveolar lavage fluid and lung biopsy.Treatment includes avoiding the allergen and systemic corticosteroids.The long-term prognosis is usually good.