's general knowledge of calm disease of alveolus albumen

's general knowledge of calm disease of alveolus albumen
[Sum up ]
Protein calm disease (pulmonary alveolar proteinosis) of the alveolus Mean the filling the air albumen is calm in the alveolus with unidentified reason, by Rose in 1958 report at first, the literature reports about 400- 500 so far, our country is in 1965 the first reports. Regard going on shortness of breath as the characteristic clinically, it is a main means to diagnose and treat that the bronchus alveolus is irritated and washed. The prognosis differs greatly, have it healing, die in one, two years after finding too.
[Diagnose ]
The chest X-ray is shown as and soaked to the disposition alveolus but is not be in the mood for declining and displaying and acting as doubting and a disease. Bronchus alveolus irritate, have one's hair washed as muddy now, milky white or yellow liquid, there is a large amount of that does not have having a liking for his red body of structure while precipitating in it, then diagnosis is very clear. If combine the bronchus mirror lung and live and examine diagnosing and fixing even more. Seldom need to open the chest lung and live and examine at present. The report thinks that determines the active albumen A of surface is a kind of simple and convenient auxiliary diagnosis means in the phlegm.
[Treat the measure ]
Have not found the effective medicine yet. The ones that adopted irritated washing for the bronchus alveolus effectively at present and extensively, there are conditions and should be irritated and washed in the down complete lung of general anesthesia. Prop up under the mirror dividing into the leaf, irritating and washing by stage while being fine while being feasible. Result similar, but patient to fine to prop up the intersection of mirror and law to be difficult to tolerate, can't until high capacity irritate wash very.
[The cause of disease is studied ]
The cause of disease has not been bright, infer that relates to several respect factors: For instance a large amount of dust is sucked (aluminium, oxidize silicons,etc. two times) ,Organism immunological function drops ' Especially infant and pre-school children) ,Inherent cause, get drunk, the microorganism is infected with etc.. And for infect, sometimes very difficult to confirm, send, cause cause of disease to be plain or continue, take place at the intersection of the alveolus and the intersection of albumen and calm disease originally. Such as the virus of big and small afterbirth, the lung sporozoite of card, organizes the afterbirth thick liquid fungus to infect etc. finding that there is calm high protein in alveoluses.
Though it is still indeterminate to start the factor, basically agree that the course is due to lipid supersession obstacle to have illness coming on. Namely because factor function causes metabolic disorder of the pulmonary surfactant in, outside the organism. Up till now, alveolus macrophage vigors to study more one, animal's experiment proves their vigor obviously drops after macrophages engulf the dust, and the patient can make normal cell vigor drop to irritate the macrophage inner particles in lotion, after the bronchus alveolus is irritated and washes and treats, its macrophage vigor of alveolus can rise. Study and has not found Model 2 cells turn into the albumen to increase, the lipoprotein supersession of whole body is not unusual. So generally think a disease drops and has something to do with with removing ability at present.
[Pathology changes ]
Huge to examine revealing the lung is dirty can obviously become hard, the weight increases. Consolidation of lung and compensating pulmonary emphysema to coexist. The alveolus structure is basically normal under the mere mirror, full of thin granular PAS without structure and dye the positive albumen - like material in the alveolus, 2type cell hyperplasia, it is loose,afterbirth increase board layers of bodies little in thick liquid,the layers of bodies littles arrange as concentric circles form in board. Number of macrophage and volume obviously increase. Among lung can fiber and take quality appear,on is there author to be mentioned clavicular at lymph node can checking and albumen - like material.
[Clinical manifestation ]
Men and women's ratio is 2- 3: 1,Can happen at any age, the majority is among 20-50 years old. Get up disease hide, for shortness of breath of going on etc. main symptom. About 1/3 of the cases have low-heat, major part coughs, the phlegm takes the form of milky white foam, see the bulk, jelly or in charge ofing type expectorate sometimes. Can breathe sports to weaken in physical examination, the slight voiced sound of percussion, the obvious pathology bronchus respiration in the lung, there is a wet rale occasionally. Serious disease has poke pointing, manifestation of cyanosis and lung artery high pressure.
The X-ray is shown as the filling the air alveolus is soaked on the lung door, take the form of butterfly, dual sides might not be very symmetrical, like the lung edema very much.
[Prognosis ]
The prognostic difference of the patients of children, die in several years, there are the adult philtrums healing the case, also have, recur patient heal, about half the a patient in order to develop progressively, or erupt simultaneously and infect, breathe depletedly but in 5- 10 death.
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