慢性嗜酸性粒细胞性肺炎四例报道并文献复习_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

田仕莉 ^1,2 , 侯彦姣 ³ , 安若丽 ⁴ , 兰丽珍 ¹ ,  蒋毅 ⁴

1. ;
2. ;
3. ;
4. ;

Corresponding author：

蒋毅, Email: 8jiangyi@163.com

Keywords：

慢性嗜酸性粒细胞肺炎; 吸入性糖皮质激素; 治疗

DOI：

10.7507/1671-6205.202504028

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目的总结分析慢性嗜酸性粒细胞肺炎（chronic eosinophil pneumonia，CEP）的临床特点，提高临床医生对本病的认识。方法收集山西医科大学第一医院呼吸与危重症医学科2021年5月—2023年9月收治的4例CEP的临床资料，对其临床特点、诊疗过程进行回顾性分析。结果 4例患者中，男性和女性各2例，年龄为22～52岁。所有患者均有咳嗽症状，其中3例伴有咳痰，1例伴有喘息，平均病程4～6个月就诊。4例患者外周血嗜酸性粒细胞及支气管肺泡灌洗液嗜酸性粒细胞百分比均不同程度升高。胸部CT显示4例患者均存在双肺病变及以外周为主的斑片状实变影。所有患者均给予口服激素治疗半年以上序贯吸入激素治疗，症状均好转，肺部磨玻璃影明显吸收，随访10～32个月均未见复发。结论 CEP临床表现无特异性，治疗不规范易复发，考虑全身糖皮质激素疗程结束后序贯吸入激素治疗可降低复发率。患者管理可参照哮喘慢病管理策略，监测外周血嗜酸性细胞及胸部CT调整用药。

Citation： 田仕莉, 侯彦姣, 安若丽, 兰丽珍, 蒋毅. 慢性嗜酸性粒细胞性肺炎四例报道并文献复习. Chinese Journal of Respiratory and Critical Care Medicine, 2025, 24(8): 579-582. doi: 10.7507/1671-6205.202504028 Copy

1.	Carrington CB, Addington WW, Goff AM, et al. Chronic eosinophilic pneumonia. N Engl J Med, 1969, 280(15): 787-798.
2.	Jederlinic PJ, Sicilian L, Gaensler EA. Chronic eosinophilic pneumonia. A report of 19 cases and a review of the literature. Medicine, 1988, 67(3): 154-162.
3.	Marchand E, Reynaud-Gaubert M, Lauque D, et al. Idiopathic chronic eosinophilic pneumonia. A clinical and follow-up study of 62 cases. Medicine, 1998, 77(5): 299-312.
4.	Cottin V, Cordier JF. Eosinophilic pneumonias. Allergy, 2005, 60(7): 841-857.
5.	Suzuki Y, Suda T. Long-term management and persistent impairment of pulmonary function in chronic eosinophilic pneumonia: a review of the previous literature. Allergol Int, 2018, 67(3): 334-340.
6.	Marchand E, Etienne-Mastroianni B, Chanez P, et al. Idiopathic chronic eosinophilic pneumonia and asthma: how do they influence each other? Eur Respir J, 2003, 22(1): 8-13.
7.	王梓瑞, 许阳. 嗜酸性粒细胞肺炎病例1例及相关文献回顾. 中国临床案例成果数据库, 2022, 4(1): E02238.
8.	Carbone RG, Puppo F, Mattar E, et al. Acute and chronic eosinophilic pneumonia: an overview. Front Med, 2024, 11: 1355247.
9.	Durieu J, Wallaert B, Tonnel AB. Long-term follow-up of pulmonary function in chronic eosinophilic pneumonia. Eur Respir J, 1997, 10(2): 286-291.
10.	Oyama Y, Fujisawa T, Hashimoto D, et al. Efficacy of short-term prednisolone treatment in patients with chronic eosinophilic pneumonia. Eur Respir J, 2015, 45(6): 1624-1631.
11.	Ishiguro T, Takayanagi N, Uozumi R, et al. The long-term clinical course of chronic eosinophilic pneumonia. Intern Med, 2016, 55(17): 2373-2377.
12.	Suzuki Y, Oyama Y, Hozumi H, et al. Persistent impairment on spirometry in chronic eosinophilic pneumonia: a longitudinal observation study (Shizuoka-CEP study). Ann Allergy Asthma Immunol, 2017, 119(5): 422-428.
13.	Fox B, Seed WA. Chronic eosinophilic pneumonia. Thorax, 1980, 35(8): 570-580.
14.	桑节峰, 万珙善, 谷佃宝. 慢性嗜酸性细胞肺炎的影像学表现(附16例分析). 医学影像学杂志, 2010, 20(1): 30-32.
15.	Marchand E, Cordier JF. Idiopathic chronic eosinophilic pneumonia. Orphanet J Rare Dis, 2006, 27(2): 134-141.
16.	Suzuki Y, Suda T. Eosinophilic pneumonia: a review of the previous literature, causes, diagnosis, and management. Allergol Int, 2019, 68(4): 413-419.
17.	Derendorf H, Hochhaus G, Meibohm B, et al. Pharmacokinetics and pharmacodynamics of inhaled corticosteroids. J Allergy Clin Immunol, 1998, 101(4): S440-S446.
18.	Minakuchi M, Niimi A, Matsumoto H, et al. Chronic eosinophilic pneumonia: treatment with inhaled corticosteroids. Respiration, 2003, 70(4): 362-366.
19.	Naughton M, Fahy J, FitzGerald MX. Chronic eosinophilic pneumonia. a long-term follow-up of 12 patients. Chest, 1993, 103(1): 162-165.
20.	Alam M, Burki NK. Chronic eosinophilic pneumonia: a review. South Med J, 2007, 100(1): 49-53.
21.	Chan C, DeLapp D, Nystrom P. Chronic eosinophilic pneumonia: adjunctive therapy with inhaled steroids. Respir Med Case Rep, 2017, 22: 11-14.
22.	杨天芸, 韩锋锋, 宋琳, 等. 慢性嗜酸性粒细胞性肺炎五例临床分析. 中国呼吸与危重监护杂志, 2017, 16(3): 265-270.

1. Carrington CB, Addington WW, Goff AM, et al. Chronic eosinophilic pneumonia. N Engl J Med, 1969, 280(15): 787-798.
2. Jederlinic PJ, Sicilian L, Gaensler EA. Chronic eosinophilic pneumonia. A report of 19 cases and a review of the literature. Medicine, 1988, 67(3): 154-162.
3. Marchand E, Reynaud-Gaubert M, Lauque D, et al. Idiopathic chronic eosinophilic pneumonia. A clinical and follow-up study of 62 cases. Medicine, 1998, 77(5): 299-312.
4. Cottin V, Cordier JF. Eosinophilic pneumonias. Allergy, 2005, 60(7): 841-857.
5. Suzuki Y, Suda T. Long-term management and persistent impairment of pulmonary function in chronic eosinophilic pneumonia: a review of the previous literature. Allergol Int, 2018, 67(3): 334-340.
6. Marchand E, Etienne-Mastroianni B, Chanez P, et al. Idiopathic chronic eosinophilic pneumonia and asthma: how do they influence each other? Eur Respir J, 2003, 22(1): 8-13.
7. 王梓瑞, 许阳. 嗜酸性粒细胞肺炎病例1例及相关文献回顾. 中国临床案例成果数据库, 2022, 4(1): E02238.
8. Carbone RG, Puppo F, Mattar E, et al. Acute and chronic eosinophilic pneumonia: an overview. Front Med, 2024, 11: 1355247.
9. Durieu J, Wallaert B, Tonnel AB. Long-term follow-up of pulmonary function in chronic eosinophilic pneumonia. Eur Respir J, 1997, 10(2): 286-291.
10. Oyama Y, Fujisawa T, Hashimoto D, et al. Efficacy of short-term prednisolone treatment in patients with chronic eosinophilic pneumonia. Eur Respir J, 2015, 45(6): 1624-1631.
11. Ishiguro T, Takayanagi N, Uozumi R, et al. The long-term clinical course of chronic eosinophilic pneumonia. Intern Med, 2016, 55(17): 2373-2377.
12. Suzuki Y, Oyama Y, Hozumi H, et al. Persistent impairment on spirometry in chronic eosinophilic pneumonia: a longitudinal observation study (Shizuoka-CEP study). Ann Allergy Asthma Immunol, 2017, 119(5): 422-428.
13. Fox B, Seed WA. Chronic eosinophilic pneumonia. Thorax, 1980, 35(8): 570-580.
14. 桑节峰, 万珙善, 谷佃宝. 慢性嗜酸性细胞肺炎的影像学表现(附16例分析). 医学影像学杂志, 2010, 20(1): 30-32.
15. Marchand E, Cordier JF. Idiopathic chronic eosinophilic pneumonia. Orphanet J Rare Dis, 2006, 27(2): 134-141.
16. Suzuki Y, Suda T. Eosinophilic pneumonia: a review of the previous literature, causes, diagnosis, and management. Allergol Int, 2019, 68(4): 413-419.
17. Derendorf H, Hochhaus G, Meibohm B, et al. Pharmacokinetics and pharmacodynamics of inhaled corticosteroids. J Allergy Clin Immunol, 1998, 101(4): S440-S446.
18. Minakuchi M, Niimi A, Matsumoto H, et al. Chronic eosinophilic pneumonia: treatment with inhaled corticosteroids. Respiration, 2003, 70(4): 362-366.
19. Naughton M, Fahy J, FitzGerald MX. Chronic eosinophilic pneumonia. a long-term follow-up of 12 patients. Chest, 1993, 103(1): 162-165.
20. Alam M, Burki NK. Chronic eosinophilic pneumonia: a review. South Med J, 2007, 100(1): 49-53.
21. Chan C, DeLapp D, Nystrom P. Chronic eosinophilic pneumonia: adjunctive therapy with inhaled steroids. Respir Med Case Rep, 2017, 22: 11-14.
22. 杨天芸, 韩锋锋, 宋琳, 等. 慢性嗜酸性粒细胞性肺炎五例临床分析. 中国呼吸与危重监护杂志, 2017, 16(3): 265-270.

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