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对2014年1月至2019年6月北京大学第三医院呼吸与危重症医学科确诊的4例急性嗜酸粒细胞性肺炎（AEP）患者的临床资料进行回顾性分析。4例AEP患者均为男性，年龄28~68岁，均以发热、咳嗽、呼吸困难为主要表现，3例有吸烟史，1例有溃疡性结肠炎病史。支气管肺泡灌洗液（BALF）嗜酸粒细胞比例分别为85%、93%、41%、50%，外周血嗜酸粒细胞比例（计数）分别为53.3%（16.29×10n 9/L）、25.1%（1.29×10n 9/L）、4.8%（0.4×10n 9/L）、13.7%（1.55×10n 9/L）。动脉血气分析（未吸氧）1例为Ⅰ型呼吸衰竭，3例为低氧血症。外周血总IgE（正常范围≤100.0 KU/L）分别为>2 500.0、60.3、379.4、407.0 KU/L。高分辨胸部CT显示病灶均呈双肺弥漫分布，表现为磨玻璃影、片状实变影和小叶中心结节。确诊后均用糖皮质激素治疗，发热、咳嗽及呼吸困难均明显改善，胸部CT病灶明显吸收。分别随访29、16、18、24个月，均无复发。AEP临床少见，外周血嗜酸粒细胞增多具有提示意义，及时进行BALF细胞分类可尽早明确诊断。n “,”The clinical data of 4 patients with acute eosinophilic pneumonia (AEP) diagnosed in the Department of Respiratory and Critical Care Medicine, Peking University Third Hospital were retrospectively analyzed. All 4 patients were males, aged 28, 34, 43 and 68 years respectively. The main manifestations were fever, cough and dyspnea. Three cases had a history of smoking and 1 case had a history of ulcerative colitis. The proportion of eosinophils in bronchoalveolar lavage fluid (BALF) was 85%, 93%, 41% and 50%, respectively. The proportion of eosinophils in peripheral blood was 53.3% (16.29×10n 9/L), 25.1% (1.29×10n 9/L), 4.8% (0.4×10n 9/L) and 13.7% (1.55×10n 9/L), respectively. Blood gas analysis (without supplemental oxygen) showed type I respiratory failure in 1 case, hypoxemia in 3 cases. The total IgE (normal range ≤ 100.0 KU/L) in peripheral blood of the 4 cases was>2 500.0 KU/L, 60.3 KU/L, 379.4 KU/L and 407.0 KU/L, respectively. HRCT showed diffuse distribution of lesions in both lungs, including ground glass opacity, patchy consolidation and centrilobular nodules. After diagnosis, all patients were treated with systemic glucocorticoids. Fever, cough and dyspnea, as well as the chest CT lesions were significantly improved after treatment. The patients were followed up for 29 months, 16 months, 18 months and 24 months respectively, without recurrence. AEP is a rare disease which is easy to be misdiagnosed as severe pneumonia and/or ARDS. Eosinophilia in peripheral blood is suggestive of the disease, and timely BALF cell differentials is important for early diagnosis.n