Diagnosis and Treatment of Pulmonary Alveolar Proteinosis:Analysis of 34 Cases_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 LiYing , YanWei , ZhangXiaohua , LiuLang

Hunan Prevention and Treatment Center for Occupational Diseases, Changsha, Hunan, 410007, China;

Corresponding author：

LiYing, Email: liying9858@163.com

Keywords：

Pulmonary alveolar proteinosis; Inhalation of dust; Whole lung lavage; Recurrence

DOI：

10.7507/1671-6205.2016093

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Objective To improve the diagnosis and treatment of pulmonary alveolar proteinosis (PAP). Methods The clinical data of 34 PAP cases diagnosed between May 2008 and June 2015 in Hunan Prevention and Treatment Center for Occupational Diseases were retrospectively analyzed. Results There were 34(52.9%)patients with a history of dust exposure. Cough and progressive dyspnea were common clinical symptoms. The incidence rate of hypoxemia and lung function damage was 87.9% and 90.9%,respectively. High resolution CT clearly demonstrated the characteristic map-like changing and paving-stone sign. Arterial blood oxygen partial pressure increased from (62.5±12.9)mm Hg to (73.0±12.2)mm Hg,and D_LCO%pred increased from (50.1±14.9)% to (64.6±14.4)% after large-volume whole lung lavage. The recurrence rate was 38.2%. Conclusion The etiology of PAP is unknown,dust exposure may be associated with secondary PAP. The effect of whole lung lavage is remarkable but the recurrence rate is high. It is needed to study further on etiological treatment of PAP.

Citation： LiYing, YanWei, ZhangXiaohua, LiuLang. Diagnosis and Treatment of Pulmonary Alveolar Proteinosis:Analysis of 34 Cases. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(4): 398-400. doi: 10.7507/1671-6205.2016093 Copy

1.	余巍巍, 曾锦荣,王昌明,等.国内20年肺泡蛋白沉积症误诊原因汇总分析.中国综合临床,2009,25:1276-1278.
2.	Rosen SH,Castleman B,Liebow AA.Pulmonary alveolar proteinosis. N Engl J Med,1958,258:1123-1142.
3.	张弘, 邵池,彭敏,等.肺泡蛋白沉积症84例误诊误治分析.中国实用内科杂志,2009,29:426-428.
4.	Shah PL,Hansell D,Lawson DR,et al. Pulmonary alveolar proteinosis:clinical aspects and current concepts on pathogenesis. Thorax,2000,55:67-77.
5.	朱元珏, 陈文彬,主编.呼吸病学.北京:人民卫生出版社,2002,1106-1111.
6.	张新静, 肖永龙,蔡后荣,等.自身免疫性肺泡蛋白沉积症患者临床影像学特征与生物学标志的关系.中国呼吸与危重监护杂志,2014,13:389-393.
7.	Arai T,Inoue Y,Sugimoto C,et al.CYFRA 21-1 as a disease severity marker for autoimmune pulmonary alveolar proteinosis. Respirology,2014,19:246-252.
8.	刘娟, 向萍.可疑慢性粉尘接触致肺泡蛋白沉积症1例报道.重庆医学,2014,43:4415-4416.
9.	叶绍色. 接尘工人肺泡蛋白沉积症10例临床分析.应用预防医学,2010,16:300-301.
10.	Bonella F,Bauer PC,Griese M,et al.Pulmonary alveolar proteinosis:New insigh from a single-center cohort of 70 patients.Respir Med,2011,105:1908-1916.
11.	Cummings KJ,Nakano M,Omae K. Indium lung disease.Chest,2012,141:1512-1521.
12.	王志兵, 张向左.肺泡蛋白沉积症的影像学特点分析.华北煤炭医学院学报,2010,12:352.
13.	Sihoe AD,Ng VM,Liu RW,et al. Pulmonary alveolar proteinosis in extremis:the case for aggressive whole lung lawage with extracorporeal membrane oxygenation suppo.Heart Lung Circ,2008,17:69-72.
14.	徐凯峰, 陈燕,郭子健,等.肺泡蛋白沉积症患者血清中抗粒-巨噬细胞集落刺激因子抗体等血清学指标的临床意义.中华结核和呼吸杂志,2004,27:824-828.
15.	闻胜兰, 吴晓虹,应可净,等.大容量全肺灌洗治疗重度肺泡蛋白沉积症五例分析.中华结核和呼吸杂志,2004,27:598-600.
16.	杨俊, 江丹,卢进昌,等.大容量全肺灌洗治疗肺泡蛋白沉积症10例疗效分析.浙江临床医学,2014,16:397-398.
17.	Ioachimescu OC,Karuru MS.Pulmonary alveolar proteinosis. Chron Respire Dis,2006,3:149-159.
18.	Tazawa R,Trapnell BC,Inoue Y,et al.Inhaled granulocyte/macrophage-colony stimulating factor as therapy for pulmonary alveolar proteinosis.Am J Respir Crit Care Med,2010,181:1345-1354.

1. 余巍巍, 曾锦荣,王昌明,等.国内20年肺泡蛋白沉积症误诊原因汇总分析.中国综合临床,2009,25:1276-1278.
2. Rosen SH,Castleman B,Liebow AA.Pulmonary alveolar proteinosis. N Engl J Med,1958,258:1123-1142.
3. 张弘, 邵池,彭敏,等.肺泡蛋白沉积症84例误诊误治分析.中国实用内科杂志,2009,29:426-428.
4. Shah PL,Hansell D,Lawson DR,et al. Pulmonary alveolar proteinosis:clinical aspects and current concepts on pathogenesis. Thorax,2000,55:67-77.
5. 朱元珏, 陈文彬,主编.呼吸病学.北京:人民卫生出版社,2002,1106-1111.
6. 张新静, 肖永龙,蔡后荣,等.自身免疫性肺泡蛋白沉积症患者临床影像学特征与生物学标志的关系.中国呼吸与危重监护杂志,2014,13:389-393.
7. Arai T,Inoue Y,Sugimoto C,et al.CYFRA 21-1 as a disease severity marker for autoimmune pulmonary alveolar proteinosis. Respirology,2014,19:246-252.
8. 刘娟, 向萍.可疑慢性粉尘接触致肺泡蛋白沉积症1例报道.重庆医学,2014,43:4415-4416.
9. 叶绍色. 接尘工人肺泡蛋白沉积症10例临床分析.应用预防医学,2010,16:300-301.
10. Bonella F,Bauer PC,Griese M,et al.Pulmonary alveolar proteinosis:New insigh from a single-center cohort of 70 patients.Respir Med,2011,105:1908-1916.
11. Cummings KJ,Nakano M,Omae K. Indium lung disease.Chest,2012,141:1512-1521.
12. 王志兵, 张向左.肺泡蛋白沉积症的影像学特点分析.华北煤炭医学院学报,2010,12:352.
13. Sihoe AD,Ng VM,Liu RW,et al. Pulmonary alveolar proteinosis in extremis:the case for aggressive whole lung lawage with extracorporeal membrane oxygenation suppo.Heart Lung Circ,2008,17:69-72.
14. 徐凯峰, 陈燕,郭子健,等.肺泡蛋白沉积症患者血清中抗粒-巨噬细胞集落刺激因子抗体等血清学指标的临床意义.中华结核和呼吸杂志,2004,27:824-828.
15. 闻胜兰, 吴晓虹,应可净,等.大容量全肺灌洗治疗重度肺泡蛋白沉积症五例分析.中华结核和呼吸杂志,2004,27:598-600.
16. 杨俊, 江丹,卢进昌,等.大容量全肺灌洗治疗肺泡蛋白沉积症10例疗效分析.浙江临床医学,2014,16:397-398.
17. Ioachimescu OC,Karuru MS.Pulmonary alveolar proteinosis. Chron Respire Dis,2006,3:149-159.
18. Tazawa R,Trapnell BC,Inoue Y,et al.Inhaled granulocyte/macrophage-colony stimulating factor as therapy for pulmonary alveolar proteinosis.Am J Respir Crit Care Med,2010,181:1345-1354.

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