CHEST-X-RAY IN ANTI-GLOMERULAR BASEMENT-MEMBRANE ANTIBODY DISEASE (GOODPASTURES-SYNDROME)
CHEST-X-RAY IN ANTI-GLOMERULAR BASEMENT-MEMBRANE ANTIBODY DISEASE (GOODPASTURES-SYNDROME)
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DOI：
10.1016/s0009-9260(79)80223-8
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发表时间：
1979-01-01
影响因子：
2.6
通讯作者：
CHIN, WS
中科院分区：
文献类型：
--
作者：
BOWLEY, NB;STEINER, RE;CHIN, WS
本文分析了25例经证实的抗肾小球基底膜抗体病（Goodpasture综合征）的胸片。除2例外，所有患者均在疾病的某个阶段发生肺出血。有39例肺出血发作，25例复发。在7次发作期间，胸部X线片正常。肺出血复发从未单独发生，但通常与感染（不一定是胸部感染）或偶尔液体超负荷有关。如果当时循环抗体滴度高或升高，则液体超负荷或感染总是与肺出血相关。在抗肾小球基底膜抗体病患者中，无论是否存在肺水肿或胸部感染，胸片上肺野阴影的存在几乎总是意味着患者有肺出血。裂缝造成的阴影限制、横隔膜或心脏轮廓大部分消失、肺尖受累或肋膈角表明存在潜在的胸部感染。室间隔线显示体液过多。胸腔积液伴胸部感染和液体过多。即使胸片正常，肺出血时CO摄取（KCO）也总是很高。KCO和胸片联合是监测这些患者肺部疾病的最佳方法。
Chest radiographs of 25 patients with proven antiglomerular basement membrane antibody disease (Goodpasture''s syndrome) were analyzed. All patients except 2 had pulmonary hemorrhage at some stage of their disease. There were 39 pulmonary hemorrhage episodes, 25 being relapses. During 7 episodes the chest radiograph was normal. Pulmonary hemorrhage relapses never occurred in isolation but were usually associated with infection (not necessarily a chest infection) or occasionally fluid overload. Fluid overload or infection were always associated with pulmonary hemorrhage provided there were high or rising titers of circulating antibodies at the time. In a patient with antiglomerular basement membrane antibody disease, shadow presence in lung fields on the chest radiography almost invariably means the patient has pulmonary hemorrhage whether or not pulmonary edema or chest infection were present. Shadowing limitation by a fissure, loss of major portions of the diaphragmatic or cardiac silhouette, lung apex involvement or costophrenic angles suggested an underlying chest infection. Septal lines suggested fluid overload. Pleural effusions were seen with chest infections and fluid overload. The CO uptake (KCO) was invariably high in the pulmonary hemorrhage presence even if the chest radiograph was normal. Combined KCO and chest radiograph is the best method of monitoring lung disease in these patients.