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急性白血病的肺部并发症有白血病细胞浸润肺实质、感染、血小板减少引起出血、药物和放疗引起肺炎以及肺血管白细胞郁积。尸检发现急性非淋巴细胞白血病(acute nonlymphocytic leukemia,ANLL)中肺白细胞郁积(pulmonary leukostasis,PL)发生率高达35%。本文报告4例ANLL由于PL引起呼吸窘迫。 4例中男1、女3例,年龄26～69岁。外周血白细胞计数均>20万/mm~3,原细胞>70%。外周血和骨髓形态学证实为ANLL。入院时肺部检查、胸部X线摄片均正常。但开始化疗后10～48h发生急性呼吸窘迫,临床表现为发热、呼吸困难、呼吸急促、全肺满布罗音、胸膜渗出和严重低氧血症。胸部X线摄片示弥漫性肺浸润、血管充血、心脏扩大、胸膜渗
Pulmonary complications of acute leukemia leukemia cells infiltration of lung parenchyma, infection, thrombocytopenia caused by bleeding, drugs and radiotherapy cause pneumonia and pulmonary vascular leukocyte accumulation. Autopsy revealed a 35% incidence of pulmonary leukostasis (PL) in acute nonlymphocytic leukemia (ANLL). This article reports 4 cases of ANLL due to PL-induced respiratory distress. 4 cases of male 1, female 3 cases, aged 26 to 69 years. Peripheral blood leukocyte counts were> 200000 / mm ~ 3, the original cells> 70%. Peripheral blood and bone marrow morphology confirmed as ANLL. Lung examination on admission, chest X-ray were normal. However, acute respiratory distress occurs 10 to 48 hours after the start of chemotherapy. The clinical manifestations include fever, dyspnea, shortness of breath, whole-lung Manbuluo, pleural exudation, and severe hypoxemia. Chest X-ray showed diffuse pulmonary infiltration, vascular congestion, enlargement of the heart, pleural infiltration