中文摘要：

目的提高临床医生对隐源性机化性肺炎（COP）的认识，减少误诊误治。方法对四川大学华西医院2006年1月至2011年10月22例COP患者的临床表现、实验室检查、影像学结果、治疗等资料进行回顾性分析。结果COP的主要临床症状是咳嗽（95．45％），缺乏特征性。实验室检查中最常表现为血沉增快（71．43％）。肺功能多为不同程度的弥散功能障碍。影像学较具特征性，多以双肺多发实变影、斑片状影（63．64％）为主，支气管充气征（54．55％）常见，病灶可以表现为游走、迁徙。经纤维支气管镜肺行病理活检是诊断COP的常用手段。绝大多数患者抗生素治疗无反应，而糖皮质激素治疗有效。本病通常预后良好。结论COP临床表现及实验室检查不具有特征性，初始影像学表现类似肺炎。提高对本病的认识，减少误诊，有助于避免抗生素的不合理使用，改善病人的预后。

英文摘要：

Objective To improve the knowledge of cryptogenic organizing pneumonia （COP） ,and reduce misdiagnosis and mistreatment. Methods The medical records of 22 patients with biopsy-proven COP from January 2006 to October 2011 were retrospectively reviewed. The clinical presentation, laboratory data,radiographic results and treatment were collected and analyzed. Results The clinical presentations were nonspecific, and the most common symptom of COP was cough （95.45%）. The laboratory data analysis revealed that elevated erythroeyte sedimentation rate in 71.43% of the COP patients. The COP patients usually presented with a restrictive ventilation dysfunction and decreased diffuse function on pulmonary function test. The most common patterns of lung abnormality on chest CT scan were bilaterally multifocal patchy consolidation or ground-glass opacification （ 63.64% ） , which distributed along the bronchovascular bundles or subpleural lungs. Patchy consolidation with air bronchograms was also a common feature （54. 55% ）. Migration over time and spontaneous remission of consolidation were important pointers. Histopathology by transbronchial lung biopsy was a valuable means for diagnosis. The majority of COP patients were non-response to antibiotics, but responded rapidly and completely to oral administration of corticosteroids with good prognosis. Conclusions The clinical presentations and laboratory data of COP patients are nonspecific. Initial imaging findings of COP are similar with pneumonia. Strengthening the recognition of COP is conducive to reducing misdiagnosis and reasonable antibiotics use.