lung

  • 文章类型: Journal Article
    完全靶向的mRNA治疗需要同时的器官特异性积累和有效的翻译。尽管取得了一些进展,交付系统仍然无法完全实现这一目标。这里,我们通过调整脂质材料结构和组成来重组脂质纳米颗粒(LNPs),以系统地实现肺和肝(分别)靶向的mRNA分布和表达。设计了基于可降解核心的可电离阳离子脂质的组合库,接下来是LNP成分的优化。与当前的LNP范式相反,我们的研究结果表明,胆固醇和磷脂对于LNP功能是可有可无的.具体来说,胆固醇去除解决了防止纳米颗粒在肝组织中积累的持续挑战。通过调制和简化固有的LNP组件,在肺和肝中同时实现mRNA积累和翻译,分别。这种靶向策略适用于现有的LNP系统,有可能扩大各种疾病的精确mRNA治疗的进展。
    Fully targeted mRNA therapeutics necessitate simultaneous organ-specific accumulation and effective translation. Despite some progress, delivery systems are still unable to fully achieve this. Here, we reformulate lipid nanoparticles (LNPs) through adjustments in lipid material structures and compositions to systematically achieve the pulmonary and hepatic (respectively) targeted mRNA distribution and expression. A combinatorial library of degradable-core based ionizable cationic lipids is designed, following by optimisation of LNP compositions. Contrary to current LNP paradigms, our findings demonstrate that cholesterol and phospholipid are dispensable for LNP functionality. Specifically, cholesterol-removal addresses the persistent challenge of preventing nanoparticle accumulation in hepatic tissues. By modulating and simplifying intrinsic LNP components, concurrent mRNA accumulation and translation is achieved in the lung and liver, respectively. This targeting strategy is applicable to existing LNP systems with potential to expand the progress of precise mRNA therapy for diverse diseases.
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  • 文章类型: Journal Article
    作为空气交换的场所,肺组织长期暴露于大量的外来病原体。因此,肺已经发展出精致而复杂的免疫系统。除了它们的物理和化学屏障作用,肺上皮细胞可通过表达Toll样受体(TLRs)和其他模式识别受体,随着细胞因子的分泌。新的证据表明,肺上皮细胞可以产生和分泌免疫球蛋白(Ig),包括IgM,IgA,或IgG,从而执行抗体功能。此外,已经发现恶性转化的肺上皮细胞产生高水平的Ig,主要是IgG,不能实现抗体的作用,而是进行促进肿瘤的活动。结构分析表明,由于独特的糖基化修饰,肺癌细胞产生的IgG的生物学活性与正常肺上皮细胞产生的Ig的生物学活性不同。具体来说,唾液酸化IgG(SIA-IgG),以在IgyCH1的Asn162位点的非传统N-糖基化修饰为特征,在肿瘤干细胞中高度表达。已经证明SIA-IgG依赖于这种独特的唾液酸化修饰来促进肿瘤发生。转移,和免疫逃避。目前的研究结果证明,肺上皮细胞产生的Ig具有多方面的生物学活性,包括生理条件下的免疫防御功能,同时在恶性转化过程中获得促进肿瘤的活性。这些见解作为新的生物标志物和靶标,具有诊断和治疗肺癌的潜力。
    As the locus for air exchange, lung tissue is perpetually exposed to a significant quantity of foreign pathogens. Consequently, lung has developed a refined and intricate immune system. Beyond their physical and chemical barrier roles, lung epithelial cells can contribute to immune defence through the expression of Toll-like receptors (TLRs) and other pattern recognition receptors, along with the secretion of cytokines. Emerging evidence demonstrates that lung epithelial cells can generate and secrete immunoglobulins (Igs), including IgM, IgA, or IgG, thus performing antibody function. Moreover, malignantly transformed lung epithelial cells have been discovered to produce high levels of Ig, predominantly IgG, which do not fulfill the role of antibodies, but instead carries out tumour-promoting activity. Structural analysis has indicated that the biological activity of IgG produced by lung cancer cells differs from that of Igs produced by normal lung epithelial cells due to the unique glycosylation modification. Specifically, the sialylated IgG (SIA-IgG), characterised by a non-traditional N-glycosylation modification at the Asn162 site of Igγ CH1, is highly expressed in tumour stem cells. It has been demonstrated that SIA-IgG relies on this unique sialylation modification to promote tumorigenesis, metastasis, and immune evasion. Current results have proven that the Ig produced by lung epithelial cells has multifaceted biological activities, including immune defence functions under physiological conditions, while acquiring tumour-promoting activity during malignant transformation. These insights possess potential for the diagnosis and treatment of lung cancer as novel biomarkers and targets.
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  • 文章类型: Journal Article
    背景:犬流感病毒(CIV)的爆发引起了极大的关注,因为它对狗的健康构成了重大威胁。在小猎犬的H3N2CIV进化过程中,该病毒在2019年后形成了新的进化枝,并逐渐对其他哺乳动物更具适应性。因此,成功阐明其生物学特性并构建犬流感感染模型是CIV表征所必需的。
    方法:我们进行了遗传分析以检查CIV的生物学特征和感染动力学。
    结果:我们的H3N2CIV株(来自2019年上海)的基因型属于5.1支,现在在中国很普遍。使用MDCK细胞,我们调查了病毒性细胞病变的影响。使用透射电子显微镜观察病毒大小和形态。小猎犬也感染了104、105和10650%的鸡蛋感染剂量(EID50)。与其他组相比,106EID50组表现出最明显的临床症状,病毒滴度最高,典型的肺部病理改变。我们的结果表明,其他两种治疗方法均引起轻度的临床表现和病理变化。随后,通过苏木精和伊红(H&E)和免疫荧光(IF)染色检测106EID50组的CIV分布,这表明CIV主要感染了肺部。
    结论:本研究建立的框架将指导进一步的CIV预防策略。
    BACKGROUND: The canine influenza virus (CIV) outbreak has garnered considerable attention as it poses a significant threat to dog health. During the H3N2 CIV evolution in beagles, the virus formed a new clade after 2019 and gradually became more adaptable to other mammals. Therefore, successfully elucidating the biological characteristics and constructing a canine influenza infection model is required for CIV characterization.
    METHODS: We performed genetic analyses to examine the biological characteristics and infection dynamics of CIV.
    RESULTS: The genotype of our H3N2 CIV strain (from 2019 in Shanghai) belonged to the 5.1 clade, which is now prevalent in China. Using MDCK cells, we investigated viral cytopathic effects. Virus size and morphology were observed using transmission electron microscopy. Beagles were also infected with 104, 105, and 106 50% egg-infectious doses (EID50). When compared with the other groups, the 106 EID50 group showed the most obvious clinical symptoms, the highest virus titers, and typical lung pathological changes. Our results suggested that the other two treatments caused mild clinical manifestations and pathological changes. Subsequently, CIV distribution in the 106 EID50 group was detected by hematoxylin and eosin (H&E) and immunofluorescence (IF) staining, which indicated that CIV primarily infected the lungs.
    CONCLUSIONS: The framework established in this study will guide further CIV prevention strategies.
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  • 文章类型: Journal Article
    目的:探讨影响降脂药物表达或功能的遗传变异与哮喘风险的相关性。
    方法:我们使用与降脂药物靶标相关的几种基因的变异体进行了孟德尔随机化(MR)分析:HMGCR(他汀类药物靶标),PCSK9(alirocumab目标),NPC1L1(依泽替米贝目标),APOB(mipomersen目标),ANGPTL3(evinacumab目标),PPARA(非诺贝特靶点),和APOC3(volanesorsen目标),以及LDLR和LPL。我们的目的是通过MR研究降脂药物与哮喘之间的关系。最后,我们使用MREgger和逆方差加权(IVW)方法评估了MR分析的有效性和稳定性.
    结果:发现与APOC3和LPL目标相关的甘油三酯(TG)水平升高会增加哮喘风险。相反,LDLR导致的较高LDL-C水平可降低哮喘风险.此外,LDL-C水平(由APOB驱动,NPC1L1和HMGCR目标)和TG水平(由LPL目标驱动)与改善的肺功能(FEV1/FVC)相关。由PCSK9驱动的LDL-C水平与肺功能降低(FEV1/FVC)相关。
    结论:结论:我们的发现提示哮喘与降脂药物之间可能存在因果关系.此外,有令人信服的证据表明,降脂治疗可能在哮喘的未来治疗中发挥关键作用.
    OBJECTIVE: To explore the correlation between asthma risk and genetic variants affecting the expression or function of lipid-lowering drug targets.
    METHODS: We conducted Mendelian randomization (MR) analyses using variants in several genes associated with lipid-lowering medication targets: HMGCR (statin target), PCSK9 (alirocumab target), NPC1L1 (ezetimibe target), APOB (mipomersen target), ANGPTL3 (evinacumab target), PPARA (fenofibrate target), and APOC3 (volanesorsen target), as well as LDLR and LPL. Our objective was to investigate the relationship between lipid-lowering drugs and asthma through MR. Finally, we assessed the efficacy and stability of the MR analysis using the MR Egger and inverse variance weighted (IVW) methods.
    RESULTS: The elevated triglyceride (TG) levels associated with the APOC3, and LPL targets were found to increase asthma risk. Conversely, higher LDL-C levels driven by LDLR were found to decrease asthma risk. Additionally, LDL-C levels (driven by APOB, NPC1L1 and HMGCR targets) and TG levels (driven by the LPL target) were associated with improved lung function (FEV1/FVC). LDL-C levels driven by PCSK9 were associated with decreased lung function (FEV1/FVC).
    CONCLUSIONS: In conclusion, our findings suggest a likely causal relationship between asthma and lipid-lowering drugs. Moreover, there is compelling evidence indicating that lipid-lowering therapies could play a crucial role in the future management of asthma.
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  • 文章类型: Case Reports
    背景:原发性肺粘液样肉瘤(PPMS)是一种罕见的,低度恶性肿瘤,约占所有肺肿瘤的0.2%。尽管它很罕见,PPMS具有独特的组织学特征和分子改变,特别是EWSR1-CREB1基因融合的存在。然而,其精确的组织起源仍然难以捉摸,给临床诊断带来挑战。
    一名20岁男性患者在6个月前接受了常规体检,显示肺部肿块.手术切除后,微观评估揭示了主要是短纺锤形的肿瘤细胞组织在一个束状,梁状,或网状模式。基质基质显示出丰富的粘蛋白,伴有淋巴细胞和浆细胞浸润,拉塞尔的尸体在重点区域很明显。免疫表型分析显示肿瘤细胞中波形蛋白和上皮膜抗原阳性表达,而平滑肌肌动蛋白和S-100等,是阴性的。Ki-67增殖指数约为5%。随后的第二代测序鉴定了特征性的EWSR1-CREB1基因融合体。明确的病理诊断建立了PPMS。患者未接受辅助化疗或放疗,在30个月的随访期内仍无复发。
    结论:我们报告了一例位于左肺叶叶间裂内的罕见PPMS,以肿瘤间质内的罗素身体形成为特征,PPMS中的一个新发现。此外,这个病例的组织形态特征突出了它所带来的诊断挑战,因为它可能模仿炎性肌纤维母细胞瘤,骨外粘液样软骨肉瘤,或血管外皮细胞瘤样纤维组织细胞瘤。因此,准确的诊断需要一种涉及形态学的综合方法,免疫组织化学,和分子分析。
    BACKGROUND: Primary pulmonary myxoid sarcoma (PPMS) is a rare, low-grade malignant tumor, constituting approximately 0.2% of all lung tumors. Despite its rarity, PPMS possesses distinctive histological features and molecular alterations, notably the presence of EWSR1-CREB1 gene fusion. However, its precise tissue origin remains elusive, posing challenges in clinical diagnosis.
    UNASSIGNED: A 20-year-old male patient underwent a routine physical examination 6 months prior, revealing a pulmonary mass. Following surgical excision, microscopic evaluation unveiled predominantly short spindle-shaped tumor cells organized in a fascicular, beam-like, or reticular pattern. The stromal matrix exhibited abundant mucin, accompanied by lymphocytic and plasma cell infiltration, with Russell bodies evident in focal areas. Immunophenotypic profiling revealed positive expression of vimentin and epithelial membrane antigen in tumor cells, whereas smooth muscle actin and S-100, among others, were negative. Ki-67 proliferation index was approximately 5%. Subsequent second-generation sequencing identified the characteristic EWSR1-CREB1 gene fusion. The definitive pathological diagnosis established PPMS. The patient underwent no adjuvant chemotherapy or radiotherapy and remained recurrence-free during a 30-month follow-up period.
    CONCLUSIONS: We report a rare case of PPMS located within the left lung lobe interlobar fissure, featuring Russell body formation within the tumor stroma, a novel finding in PPMS. Furthermore, the histomorphological characteristics of this case highlight the diagnostic challenge it poses, as it may mimic inflammatory myofibroblastic tumor, extraskeletal myxoid chondrosarcoma, or hemangiopericytoma-like fibrous histiocytoma. Therefore, accurate diagnosis necessitates an integrated approach involving morphological, immunohistochemical, and molecular analyses.
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  • 文章类型: Journal Article
    慢性阻塞性肺疾病(COPD)是全球发病率和死亡率的主要原因。本研究旨在阐明在免疫浸润的背景下,焦凋亡相关基因(PRGs)与COPD诊断之间的关系。最终提出了一种基于PRG的诊断模型来预测COPD结局。
    COPD患者的临床数据和PRG来自GEO数据库。“ConsensusClusterPlus”软件包用于生成从PRG衍生的分子亚型,这些亚型通过差异表达分析和LASSOCox分析进行鉴定。包括八个基因(CASP4,CASP5,ELANE,GPX4、NLRP1、GSDME、NOD1和IL18)也被建造。通过估计评分计算的免疫细胞浸润,还根据焦亡相关分子亚型和风险特征比较了基质评分和免疫评分。最后,我们用qRT-PCR检测了COPD患者和正常人群中8个基因的表达水平。
    诊断模型,锚定在八个PRG上,接受了独立实验队列的验证。诊断模型的受试者工作特征(ROC)曲线(AUC)下面积显示GSE76925、GSE8545和GSE5058数据集的值为0.809、0.765和0.956,分别。比较组之间观察到PRG的不同表达模式和临床属性,功能分析强调了它们之间免疫相关功能的差异。
    在这项研究中,我们开发了一种潜在的COPD诊断生物标志物,并在调节免疫应答中发挥重要作用.这些见解为COPD的新型诊断和治疗策略铺平了道路。
    UNASSIGNED: Chronic obstructive pulmonary disease (COPD) stands as a predominant cause of global morbidity and mortality. This study aims to elucidate the relationship between pyroptosis-related genes (PRGs) and COPD diagnosis in the context of immune infiltration, ultimately proposing a PRG-based diagnostic model for predicting COPD outcomes.
    UNASSIGNED: Clinical data and PRGs of COPD patients were sourced from the GEO database. The \"ConsensusClusterPlus\" package was employed to generate molecular subtypes derived from PRGs that were identified through differential expression analysis and LASSO Cox analysis. A diagnostic signature including eight genes (CASP4, CASP5, ELANE, GPX4, NLRP1, GSDME, NOD1and IL18) was also constructed. Immune cell infiltration calculated by the ESTIMATE score, Stroma scores and Immune scores were also compared on the basis of pyroptosis-related molecular subtypes and the risk signature. We finally used qRT - PCR to detect the expression levels of eight genes in COPD patient and normal.
    UNASSIGNED: The diagnostic model, anchored on eight PRGs, underwent validation with an independent experimental cohort. The area under the receiver operating characteristic (ROC) curves (AUC) for the diagnostic model showcased values of 0.809, 0.765, and 0.956 for the GSE76925, GSE8545, and GSE5058 datasets, respectively. Distinct expression patterns and clinical attributes of PRGs were observed between the comparative groups, with functional analysis underscoring a disparity in immune-related functions between them.
    UNASSIGNED: In this study, we developed a potential as diagnostic biomarkers for COPD and have a significant role in modulating the immune response. Such insights pave the way for novel diagnostic and therapeutic strategies for COPD.
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  • 文章类型: Journal Article
    呼吸期间胸腹器官(诸如肺)的动态特性的定量分析可以导致针对诸如胸廓功能不全综合征(TIS)的病症的更准确的手术计划。该分析可以从上述器官在胸腹部身体区域的扫描中的半自动描绘来完成。动态磁共振成像(dMRI)是这种应用的实用和首选成像模式,尽管自动分割这些图像中的器官是非常具有挑战性的。在本文中,我们描述了一个自动分割系统,该系统基于来自95名健康受试者的dMRI采集数据构建和评估.对于三种识别方法,该系统实现了肺的约1体素的最佳平均位置误差(LE)。LE的标准偏差(SD)约为1-2个体素。对于划定方法,肺的平均骰子系数(DC)约为0.95。对于肺,DC的标准偏差约为0.01至0.02。该系统似乎能够应对低分辨率带来的挑战,运动模糊,对比度不足,和图像强度非标准相当好。我们正在测试其对TIS患者dMRI数据和包括肝脏在内的其他胸腹器官的有效性,肾脏,还有脾脏.
    Quantitative analysis of the dynamic properties of thoraco-abdominal organs such as lungs during respiration could lead to more accurate surgical planning for disorders such as Thoracic Insufficiency Syndrome (TIS). This analysis can be done from semi-automatic delineations of the aforesaid organs in scans of the thoraco-abdominal body region. Dynamic magnetic resonance imaging (dMRI) is a practical and preferred imaging modality for this application, although automatic segmentation of the organs in these images is very challenging. In this paper, we describe an auto-segmentation system we built and evaluated based on dMRI acquisitions from 95 healthy subjects. For the three recognition approaches, the system achieves a best average location error (LE) of about 1 voxel for the lungs. The standard deviation (SD) of LE is about 1-2 voxels. For the delineation approach, the average Dice coefficient (DC) is about 0.95 for the lungs. The standard deviation of DC is about 0.01 to 0.02 for the lungs. The system seems to be able to cope with the challenges posed by low resolution, motion blur, inadequate contrast, and image intensity non-standardness quite well. We are in the process of testing its effectiveness on TIS patient dMRI data and on other thoraco-abdominal organs including liver, kidneys, and spleen.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    同种异体或自体造血干细胞移植是各种血液系统疾病的主要治疗手段,并显著提高了患者的生存率。但是同种异体造血干细胞移植后机体出现的移植物抗宿主病是降低患者生活质量和长期生存率的关键因素。移植物抗宿主病多表现为多器官受累,其中迟发性非感染性肺部并发症是造血干细胞移植后死亡的重要原因。在这些并发症中,闭塞性细支气管炎综合征是一种由进行性小气道疾病定义的独特临床实体,是最普遍和最具特征的晚期并发症,也是目前唯一被正式认定为肺部移植物抗宿主病的疾病实体。本文报道了1例急性白血病患者异体骨髓移植术后1年半出现移植物抗宿主病——闭塞性细支气管炎,后因重症肺炎致呼吸功能障碍行肺移植术。对患者全肺切除标本进行病理学检查,显微镜下观察见典型的闭塞性细支气管炎,此外见脏层胸膜广泛显著纤维化以及脏层胸膜下肺间质纤维化。本例受体肺病理学检查拓展了对造血干细胞移植后慢性移植物抗宿主病的肺部病理学特征的认识,为进一步临床诊疗提供可靠的病理学依据。.
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  • 文章类型: English Abstract
    Objective: To investigate and summarize pediatric patients with severe Mycoplasma pneumoniae pneumonia (MPP) presenting with varied clinical and chest imaging features in order to guide the individualized treatment. Methods: This was a retrospective cohort study. Medical records of clinical, imaging and laboratory data of 505 patients with MPP who were admitted to the Department Ⅱ of Respirology Center, Beijing Children\'s Hospital, Capital Medical University from January 2016 to October 2023 and met the enrollment criteria were included. They were divided into severe group and non-severe group according to whether lower airway obliterans was developed. The clinical and chest imaging features of the two groups were analyzed. Those severe cases with single lobe ≥2/3 consolidation (lobar consolidation) were further divided into subtype lung-necrosis and subtype non-lung-necrosis based on whether lung necrosis was developed. Comparison on the clinical manifestations, bronchoscopic findings, whole blood C-reactive protein (CRP) and other inflammatory indicators between the two subtypes was performed. Comparisons between two groups were achieved using independent-sample t-test, nonparametric test or chi-square test. Univariate receiver operating characteristic (ROC) curve analyses were performed on the indicators such as CRP of the two subtypes. Results: Of the 505 cases, 254 were male and 251 were female. The age of the onset was (8.2±2.9) years. There were 233 severe cases, among whom 206 were with lobar consolidation and 27 with diffuse bronchiolitis. The other 272 belonged to non-severe cases, with patchy, cloudy infiltrations or single lobe <2/3 uneven consolidation or localized bronchiolitis. Of the 206 cases (88.4%) severe cases with lobar consolidation, 88 harbored subtype lung-necrosis and 118 harbored subtype non-lung-necrosis. All 206 cases (100.0%) presented with persistent high fever, among whom 203 cases (98.5%) presented with inflammatory secretion obstruction and plastic bronchitis under bronchoscopy. Of those 88 cases with subtype lung-necrosis, there were 42 cases (47.7%) with dyspnea and 39 cases (44.3%) with moderate to massive amount of pleural effusion. There were 35 cases (39.8%) diagnosed with lung embolism during the disease course, of which other 34 cases (38.6%) were highly suspected. Extensive airway mucosal necrosis was observed in 46 cases (52.3%), and the level of their whole blood CRP was significantly higher than that of subtype non-lung-necrosis (131.5 (91.0, 180.0) vs. 25.5 (12.0, 43.1) mg/L, U=334.00, P<0.001). They were regarded as subtype \"lung consolidation-atelectasis-necrosis\". Of those 118 cases with subtype non-lung-necrosis, 27 cases (22.9%) presented with dyspnea and none were with moderate to massive amount of pleural effusion. Sixty-five cases (55.1%) presented with plastic bronchitis and localized airway mucosal necrosis was observed in 32 cases (27.1%). They were deemed as subtype \"lung consolidation-atelectasis\". ROC curve analyses revealed that whole blood CRP of 67.5 mg/L on the 6-10 th day of disease course exhibited a sensitivity of 0.96, a specificity of 0.89, and an area under the curve of 0.97 for distinguishing between these two subtypes among those with lobar consolidation. Conclusions: Pediatric patients with severe MPP present with lobar consolidation or diffuse bronchiolitis on chest imaging. Those with lobar consolidation harbor 2 subtypes as \"lung consolidation-atelectasis-necrosis\" and \"lung consolidation-atelectasis\". Whole blood CRP of 67.5 mg/L can be applied as an early discriminating indicator to discriminate between these two subtypes.
    目的: 总结临床和影像学等不同表现的儿童重症肺炎支原体肺炎(MPP)的临床表型。 方法: 回顾性队列研究。纳入2016年1月至2023年10月在首都医科大学附属北京儿童医院呼吸中心临床部二病区住院的505例MPP患儿的临床、影像学和实验室数据等资料。根据是否遗留下气道闭塞分为重症和非重症组,分析组间的临床和影像学特征;根据重症组影像学表现为单个肺叶≥2/3的肺实变(大叶实变)的患儿是否发生肺组织坏死分为肺组织坏死亚型及肺组织未坏死亚型,比较两个亚型的临床表现、支气管镜下表现和全血C反应蛋白(CRP)等炎症指标。组间比较采用独立样本t检验、非参数检验或χ²检验。对两个亚型的CRP等炎症指标进行单因素受试者工作特征(ROC)曲线分析。 结果: 505例MPP患儿中,男254例、女251例,起病年龄(8.2±2.9)岁。重症组233例,其中影像学表现为大叶实变206例,弥漫性细支气管炎27例;非重症组272例,影像学表现均有斑片、云絮影或单个肺叶<2/3的不均匀实变或局限性细支气管炎。206例大叶实变患儿中,肺组织坏死亚型88例、肺组织未坏死亚型118例;持续高热206例(100.0%),支气管镜下存在炎性分泌物阻塞和塑形性支气管炎203例(98.5%)。88例肺组织坏死亚型中呼吸困难42例(47.7%),合并中-大量胸腔积液39例(44.3%),病程中明确合并肺栓塞35例(39.8%),另有34例(38.6%)高度可疑,支气管镜下可见气道较为广泛的黏膜坏死46例(52.3%);肺组织坏死亚型的全血CRP水平高于肺组织未坏死亚型[131.5(91.0,180.0)比25.5(12.0,43.1)mg/L,U=334.00,P<0.001],称为“肺实变-不张-坏死型”。118例肺组织未坏死亚型中呼吸困难27例(22.9%),中-大量胸腔积液0例,支气管镜下可见塑形性支气管炎65例(55.1%),可见气道黏膜少量坏死32例(27.1%),称为“肺实变-不张型”。ROC曲线分析示病程第6~10天的全血CRP 67.5 mg/L对于在大叶实变患儿中识别出“肺实变-不张-坏死型”的灵敏度0.96,特异度0.89,曲线下面积0.97。 结论: 儿童重型MPP的影像学表现为大叶实变或弥漫性细支气管炎,其中大叶实变可分为“肺实变-不张-坏死型”和“肺实变-不张型”两个亚型,病程第6~10天的全血CRP 67.5 mg/L可作为两个亚型的早期区分指标。.
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