Lancet respir med:电子烟相关肺损伤患者尸检组织学研究

2020-08-06 MedSci原创 MedSci原创

急性至亚急性肺损伤是电子烟相关肺损伤的重要组织学证据,若患者有电子烟史且无明显的其他原因,则EVALI的可能性极高

自2019年8月以来,美国公共卫生机构一直在关注一系列电子烟相关肺损伤(EVALI)病例,对患者活检发现了一系列与急性至亚急性肺损伤相一致的组织学证据,但未进行详细的尸检研究。近日研究人员分析了美国疾病控制和预防中心(CDC)EVALI患者的尸检和活检组织的病理结果报告。
 
在2019年8月1日至2019年11月30日期间,CDC总计收到了10份肺活检和13份尸检组织样本,样本由美国16个州卫生部分提交,患者特征如下: 使用电子烟及相关产品,存在呼吸道、胃肠道或体质症状,肺部浸润或胸部影像学模糊,或因不明原因猝死。研究人员回顾了患者的医疗记录,评估了组织病理学,并进行了传染病检测。
 
21例患者符合EVALI病例定义,另有2例为临床疑似EVALI病例。所有10例肺活检结果均显示存在急性至亚急性肺损伤的组织学证据,包括弥漫性肺泡损伤或组织性肺炎,在13例尸检样本中,9例存在上述病变(69%),最常见的是弥漫性肺泡损伤(尸检8例),但也有急性和组织性纤维蛋白性肺炎(尸检1例)。对其余的尸体解剖中发现了额外的肺部病理学变化,不一定与EVALI相关,包括支气管肺炎、支气管吸入和慢性间质性肺病。尸检样本中,有3例无急性肺损伤的证据,也没有合理的替代原因。
 
研究发现,急性至亚急性肺损伤是电子烟相关肺损伤的重要组织学证据,若患者有电子烟史且无明显的其他原因,则EVALI的可能性极高。
 
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authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sat Aug 08 10:07:26 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=806712, encodeId=8e64806e128d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200921/42915b6b4a0341358462148709badb86/a4242c3ce7f146178169b217f5c7401f.jpg, createdBy=bd0e2540807, createdName=酷烨喋, createdTime=Fri Aug 07 08:29:45 CST 2020, time=2020-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033916, encodeId=df06103391687, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Thu Aug 06 22:07:26 CST 2020, time=2020-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=806616, encodeId=eab4806616af, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>基本可以排除电子烟肺炎是新冠肺炎了, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Aug 06 19:58:52 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
    2020-08-08 zhouqu_8
  5. 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createdBy=f0620, createdName=goodbing, createdTime=Thu Aug 06 22:07:26 CST 2020, time=2020-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=806616, encodeId=eab4806616af, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>基本可以排除电子烟肺炎是新冠肺炎了, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Aug 06 19:58:52 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
    2020-08-08 tastas
  6. 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time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1569953, encodeId=17a9156995303, content=<a href='/topic/show?id=5f24e007361' target=_blank style='color:#2F92EE;'>#电子烟相关肺损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70073, encryptionId=5f24e007361, topicName=电子烟相关肺损伤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=841d15610664, createdName=lhlxtx, createdTime=Sat Aug 08 10:07:26 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610643, encodeId=2407161064342, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, 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  7. 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  8. 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createdBy=f0620, createdName=goodbing, createdTime=Thu Aug 06 22:07:26 CST 2020, time=2020-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=806616, encodeId=eab4806616af, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>基本可以排除电子烟肺炎是新冠肺炎了, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Aug 06 19:58:52 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
    2020-08-07 酷烨喋

    学习

    0

  9. 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authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sat Aug 08 10:07:26 CST 2020, time=2020-08-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=806712, encodeId=8e64806e128d, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200921/42915b6b4a0341358462148709badb86/a4242c3ce7f146178169b217f5c7401f.jpg, createdBy=bd0e2540807, createdName=酷烨喋, createdTime=Fri Aug 07 08:29:45 CST 2020, time=2020-08-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033916, encodeId=df06103391687, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Thu Aug 06 22:07:26 CST 2020, time=2020-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=806616, encodeId=eab4806616af, content=<a href='/topic/show?id=46ce580e865' target=_blank style='color:#2F92EE;'>#新冠肺炎#</a>基本可以排除电子烟肺炎是新冠肺炎了, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=58078, encryptionId=46ce580e865, topicName=新冠肺炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Thu Aug 06 19:58:52 CST 2020, time=2020-08-06, status=1, ipAttribution=)]
    2020-08-06 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

  10. 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    2020-08-06 lovetcm

    #新冠肺炎#基本可以排除电子烟肺炎是新冠肺炎了

    0

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