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find Author "张秋娣" 2 results
  • 肺动脉肉瘤一例并文献复习

    目的 探讨肺动脉肉瘤(pulmonary artery sarcoma,PAS)的临床表现、影像学表现、病理学特点及鉴别诊断,提高临床医生对 PAS 的诊治水平。方法 分析1 例经病理活检确诊的 PAS 患者的临床资料并复习相关文献。结果 患者男,72 岁,因“咳嗽、胸闷半年”于 2018 年 2 月 27 日首次入院。既往体健。查体无特殊。胸部 CT 示左肺下叶见多发结节状高密度影,左肺动脉主干及分支内见斑块状低密度充盈影。诊断肺栓塞,予低分子肝素抗凝等治疗后好转出院。2018 年 4 月患者症状加重,复查 CT 肺动脉造影示左肺门增大,左肺动脉扩张,左肺动脉干管腔内巨大充盈缺损,肺动脉分叉处、左肺动脉多个分支及左心房亦可见多发充盈缺损,与首次入院时病灶相比明显进展。正电子发射断层显像检查示左肺动脉主干管腔扩张伴腔内低密度影,氟代脱氧葡萄糖代谢减低,左肺下叶结节样放射性浓聚影,SUVmax 10.3。行经肺动脉介入抽吸取栓术,病理确诊为 PAS。以“pulmonary artery sarcoma”“肺动脉肉瘤”“PAS”“pulmonary artery intimal sarcoma”“肺动脉内膜肉瘤”“PAIS”“pulmonary thromboembolism”“肺栓塞”“PTE”为关键词对国内外文献进行检索,共检索到相关文献 10 篇,涉及 506 例患者,其中男 265 例,女 241 例。PAS 患者的主要症状为咳嗽和胸闷。CT 肺动脉造影见肺动脉主干充盈缺损,可累及左右肺动脉及其分支。PAS 大都经手术确诊。病理见黏液背景中大量类似成纤维细胞或肌成纤维细胞的梭形细胞肉瘤,核异型性及有丝分裂像明显。免疫组织化学检测无特异性标志物,波形蛋白强阳性,CD31、CD34、Fli-1 不同程度阳性。手术切除是其主要的治疗手段,预后差。结论 PAS 是罕见的肺血管系统的恶性肿瘤。患者的临床表现、影像学检查和病理免疫组织化学检测无明显特异性,常被误诊为 PTE。及时诊断和早期治疗是延长患者生存时间的关键。

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  • Research on the protective effect and mechanisms of 4-phenylbutyric acid on bleomycin-induced pulmonary fibrosis in mice

    Objective To explore the effects of 4-phenylbutyric acid (4-PBA) on idiopathic pulmonary fibrosis (IPF) using a murine model of bleomycin (BLM)-induced pulmonary fibrosis. Methods Pulmonary fibrosis was induced in C57BL/6 mice by intratracheal injection of BLM. A total of 120 mice were randomly allocated into three groups: BLM group, BLM+4-PBA group, and control group. Pathology of lung tissue was analyzed to evaluate the degree of pulmonary fibrosis, and the survival of the mice was noted. The expression levels of the endoplasmic reticulum stress markers, activating transcription factor 6 (ATF6) and C/EBP homologous protein (CHOP), were analyzed in lung tissues from mice. Results BLM induced significant collagen deposition in the lungs of the mice, which was alleviated by 4-PBA. 4-PBA also dramatically improved the pulmonary function and increased the survival rate in the BLM+4-PBA group compared with that in the BLM group. Both the mRNA and protein expression levels of ATF6 and CHOP were significantly reduced in mouse lung tissue after 2 weeks of 4-PBA treatment. Conclusions 4-PBA treatment could alleviate BLM-induced pulmonary fibrosis in mice via the attenuation of endoplasmic reticulum stress.

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