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目的分析雾化吸入重组高效复合干扰素(rSIFN-co)所致机化性肺炎的临床、影像学和病理学特征及治疗。方法介绍广州医科大学附属第一医院呼吸内科收治的1例雾化吸入rSIFN-co治疗肺腺癌所致的机化性肺炎患者的临床特点及相关检查结果,并进行文献复习。结果患者男性,48岁。因肺腺癌使用rSIFN-co治疗2周后出现咳嗽、发热、气促、体重减轻;胸部高分辨率CT提示两肺多发感染性病变;抗感染治疗无效。经纤维支气管镜肺活检显示机化性肺炎。停用rSIFN-co,大剂量糖皮质激素冲击治疗后续以甲基泼尼松龙口服维持治疗后,临床症状及影像学明显改善。随访8个月,患者病情相对稳定。检索国内外文献,尚未见雾化吸入rSIFN-co治疗肺腺癌引起机化性肺炎的相关报道。结论雾化吸入rSIFN-co治疗肺腺癌可能会诱发急性机化性肺炎,临床医师应提高警惕。
Objective To analyze the clinical, imaging and pathological characteristics and treatment of patients with opportunistic pneumonia caused by inhaled recombinant rye-interferon (rSIFN-co). Methods The first hospital of Guangzhou Medical University, Department of Respiratory Medicine admitted to a case of aerosol inhaled rSIFN-co treatment of lung adenocarcinoma caused by the clinical features of patients with pneumonia and related examination results and literature review. Results The patient was male, 48 years old. Cough, fever, shortness of breath, and weight loss occurred after 2 weeks of treatment with rSIFN-co in lung adenocarcinoma. High-resolution chest CT showed multiple infectious lesions in both lungs and was ineffective in anti-infective therapy. Bronchofibroscopic lung biopsy showed organic pneumonia. After discontinuing rSIFN-co, high-dose glucocorticoid shock treatment followed by oral methylprednisolone maintenance therapy, clinical symptoms and imaging improved significantly. Follow-up 8 months, the patient’s condition is relatively stable. Retrieval of domestic and foreign literature, have not seen the inhalation of rSIFN-co treatment of lung adenocarcinoma caused by organizing pneumonia related reports. Conclusion Inhaled inhaled rSIFN-co treatment of lung adenocarcinoma may induce acute PCA, clinicians should be vigilant.