肺泡蛋白沉积症(PAP)是一种罕见的疾病,其特征是肺泡内间歇蓄积PAS染色阳性的富含磷脂的蛋白质样物质,从而影响到肺泡的气体交换,导致呼吸困难、低氧血症等一系列临床综合征。PAP可分为原发性、继发性和先天性三种类型,其中90%是原发性PAP,其发病原因不明。目前原发性PAP最常用的治疗方法是全肺灌洗术,但该治疗需在全
身麻醉下进行,设备要求高,有一定的风险,且疗效难以持久。现报告1例经过全肺灌洗术后效果不佳,再联合皮下注射重组人粒细胞-巨噬细胞集落刺激因子(rHuGlV1.CSF,特尔立,厦门特宝生物工程有限公司)治疗后病情明显好转的原发性PAP患者,并结合相关文献,以加深对这种新疗法的认识。
Citation:
张伟,李强,董宇超,姚小鹏. 全肺灌洗术联合皮下注射重组人粒细胞-巨噬细胞集落刺激因子治疗原发性肺泡蛋白沉积症一例并文献复习. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(4): 298-300. doi:
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汪琪琪,刘守智.全肺灌洗联合粒细胞-巨噬细胞集落刺激因子治疗肺泡蛋白沉积症一例.中国呼吸与危重监护杂志,2007,6:225.
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Seymour JF,Presneill JJ.Pulmonary alveolar proteinosis:progress in the first 44 years.Am J Respir Crit Care Med,2002,166:215-235.
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Stanley E,Lieschke GJ,Grail D,et al.Granulocyte/macrophage colony-stimulating factor-deficient mice show no major perturbation of hematopoiesis but develop a characteristic pulmonary pathology.Proc Natl Acad Sci USA,1994,91:5592-5596.
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Dranoff G,Crawford AD,Sadelain M,et al.Involvement of granulocyte-macrophage colony-stimulating factor in pulmonary homeostasis.Science,1994,264:713-716.
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Doerschuk CM.Pulmonary alveolar proteinosis--is host defense awry? N Engl J Med,2007,356:547-549.
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Uchida K,Beck DC,Yamamoto T,et al.GM-CSF autoantibodies and neutrophil dysfunction in pulmonary alveolar proteinosis.N Engl J Med,2007,356:567-579.
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Bonfield TL,Russell D,Burgess S,et al.Autoantibodies against granulocyte macrophage colony-stimulating factor are diagnostic for pulmonary alveolar proteinosis.Am J Respir Cell Mol Biol,2002,27:481-486.
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Reed JA,Ikegami M,Cianciolo ER,et al.Aerosolized GM-CSF ameliorates pulmonary alveolar proteinosis in GM-CSF-deficient mice.Am J Physiol,1999,276:556-563.
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Kavuru MS,Sullivan EJ,Piccin R,et al.Exogenous granulocyte-macrophage colony-stimulating factor administration for pulmonary alveolar proteinosis.Am J Respir Crit Care Med,2000,161:1143-1148.
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汪琪琪,刘守智.全肺灌洗联合粒细胞-巨噬细胞集落刺激因子治疗肺泡蛋白沉积症一例.中国呼吸与危重监护杂志,2007,6:225.
- 2. Seymour JF,Presneill JJ.Pulmonary alveolar proteinosis:progress in the first 44 years.Am J Respir Crit Care Med,2002,166:215-235.
- 3. Stanley E,Lieschke GJ,Grail D,et al.Granulocyte/macrophage colony-stimulating factor-deficient mice show no major perturbation of hematopoiesis but develop a characteristic pulmonary pathology.Proc Natl Acad Sci USA,1994,91:5592-5596.
- 4. Dranoff G,Crawford AD,Sadelain M,et al.Involvement of granulocyte-macrophage colony-stimulating factor in pulmonary homeostasis.Science,1994,264:713-716.
- 5. Doerschuk CM.Pulmonary alveolar proteinosis--is host defense awry? N Engl J Med,2007,356:547-549.
- 6. Uchida K,Beck DC,Yamamoto T,et al.GM-CSF autoantibodies and neutrophil dysfunction in pulmonary alveolar proteinosis.N Engl J Med,2007,356:567-579.
- 7. Bonfield TL,Russell D,Burgess S,et al.Autoantibodies against granulocyte macrophage colony-stimulating factor are diagnostic for pulmonary alveolar proteinosis.Am J Respir Cell Mol Biol,2002,27:481-486.
- 8. Reed JA,Ikegami M,Cianciolo ER,et al.Aerosolized GM-CSF ameliorates pulmonary alveolar proteinosis in GM-CSF-deficient mice.Am J Physiol,1999,276:556-563.
- 9. Kavuru MS,Sullivan EJ,Piccin R,et al.Exogenous granulocyte-macrophage colony-stimulating factor administration for pulmonary alveolar proteinosis.Am J Respir Crit Care Med,2000,161:1143-1148.