百草枯中毒致肺纤维化1例并文献复习

doi:10.3969/j.issn.1004-583X.2025.05.014

临床荟萃 ›› 2025, Vol. 40 ›› Issue (5): 458-462.doi: 10.3969/j.issn.1004-583X.2025.05.014

百草枯中毒致肺纤维化1例并文献复习

乔童¹^,³, 王晓冉²^,³, 陈佳星¹^,³, 付倩³, 闫莉³, 张爱丽³()

1.河北北方学院研究生院,河北张家口 075051
2.河北医科大学研究生院,河北石家庄 050017
3.河北省人民医院呼吸内科,河北石家庄 050051

收稿日期:2025-03-13 出版日期:2025-05-20 发布日期:2025-05-23
通讯作者: 张爱丽 E-mail:zhenfanggu@163.com
基金资助:
河北省2023年度医学科学研究课题——间质性肺疾病与机体微生态关系的研究(20230316)

Paraquat poisoning-induced pulmonary fibrosis: A case report and literature review

Qiao Tong¹^,³, Wang Xiaoran²^,³, Chen Jiaxing¹^,³, Fu Qian³, Yan Li³, Zhang Aili³()

1. School of Graduate, Hebei North University, Zhangjiakou 075051, China
2. School of Graduate, Hebei Medical University, Shijiazhuang 050017, China
3. Department of Respiratory, Hebei General Hospital, Shijiazhuang 050051, China

Received:2025-03-13 Online:2025-05-20 Published:2025-05-23
Contact: Zhang Aili E-mail:zhenfanggu@163.com

摘要/Abstract

摘要：

目的探讨百草枯中毒致肺纤维化的典型影像学特点。方法选取河北省人民医院呼吸内科住院患者1例,回顾性分析其影像学特点及临床资料。结果患者为18岁女性,主因腹泻5 d,咳嗽咳痰、胸闷气短3 d入院,入院后追问病史并完善相关化验检查,考虑肺炎,给予抗感染化痰等治疗后患者病情进一步加剧,反复追问病史后考虑百草枯中毒,应用甲泼尼龙联合环磷酰胺等综合治疗后,于外院行肺移植手术,术后恢复良好。结论在未知摄入百草枯的情况下,早期影像学可表现为胸膜下磨玻璃影带状分布,后快速进展为肺纤维化,这些影像学特征对于识别百草枯中毒具有一定的参考价值。

关键词: 百草枯中毒, 肺纤维化, 磨玻璃影

Abstract:

Objective To investigate the typical imaging features of pulmonary fibrosis due to paraquat poisoning. Methods Imaging and clinical data of a patient with paraquat poisoning and hospitalized in the Department of Respiratory Medicine of Hebei General Hospital were retrospectively analyzed. Results A 18-year-old female patient presented with diarrhea for 5 days, and coughing, sputum production, chest tightness, shortness of breath for 3 days. After admission, a detailed medical history was taken and relevant laboratory tests were completed. She was initially diagnosed with pneumonia and treated with anti - infection and expectorant therapies. However, her condition worsened despite the treatment. After further detailed inquiry into her medical history, paraquat poisoning was suspected. She was then treated with a combination of methylprednisolone and cyclophosphamide as part of a comprehensive treatment regimen. Subsequently, she underwent lung transplantation at another hospital and had a good postoperative recovery. Conclusion In the absence of a known ingestion of paraquat, early imaging may show subpleural ground-glass opacity with band-like distributions, which can rapidly progress to pulmonary fibrosis. These imaging features have certain reference value for identifying paraquat poisoning.

Key words: paraquat poisoning, pulmonary fibrosis, ground-glass opacity

中图分类号:

R595.9

乔童, 王晓冉, 陈佳星, 付倩, 闫莉, 张爱丽. 百草枯中毒致肺纤维化1例并文献复习[J]. 临床荟萃, 2025, 40(5): 458-462.

Qiao Tong, Wang Xiaoran, Chen Jiaxing, Fu Qian, Yan Li, Zhang Aili. Paraquat poisoning-induced pulmonary fibrosis: A case report and literature review[J]. Clinical Focus, 2025, 40(5): 458-462.

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链接本文: https://lchc.magtechjournal.com/CN/10.3969/j.issn.1004-583X.2025.05.014

https://lchc.magtechjournal.com/CN/Y2025/V40/I5/458

图/表 1

图1~3 2021年12月12日胸部CT:双肺胸膜下散在斑片状密度增高影图4~6 2021年12月17日胸部CT:双肺弥漫性病变,较前有所加重图7~9 2022年1月1日胸部CT:双肺间质性病变,背侧为著图10~12 2024年4月11日肺移植后胸部CT:胸部术后改变。双肺多发索条、条片影

Fig. 1-3 Chest CT scan on December 12, 2021 shows scattered, patchy, high-density shadows under the pleura of both lungsFig. 4-6 Chest CT scan on December 17, 2021 shows diffuse lesions in both lungs, which are aggravated compared with the previous scanFig. 7-9 Chest CT scan on January 1, 2022 shows interstitial lesions in both lungs, particularly on the dorsal sideFig. 10-12 Chest CT scan after lung transplantation on April 11, 2024 shows postoperative changes in the chest, with multiple cords and strips in both lungs

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百草枯中毒致肺纤维化1例并文献复习

Paraquat poisoning-induced pulmonary fibrosis: A case report and literature review

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