作者：张灿堂，李元芹，张淼，张晓娇，赵力

单位：

221002 江苏省徐州市，徐州医科大学附属医院呼吸内科；通信作者：赵力，E-mail：kyglan@sina.com

关键词：

肺肿瘤；血栓性微血管病；肺动脉高压；肿瘤转移；病例报告；历史文献

Keywords：

Lung neoplasms；Thrombotic microangiopathies；Pulmonary hypertension；Neoplasm metastasis；Case reports；Historical article

CLC：

R 734.2

DOI：

DOI：10.3969/j.issn.1008-5971.2020.04.023

Funds：

摘要：

肺肿瘤血栓性微血管病（PTTM）是由于肿瘤肺转移而引起的一种少见但致命的并发症，患者生前诊断较困难、预后极差。临床上遇到表现为进行性加重的呼吸困难、干咳、低氧血症、D-二聚体及纤维蛋白降解产物（FDP）升高、肺动脉高压但无肺栓塞证据的患者时需考虑 PTTM 的可能。本文报道了 1 例临床诊断为 PTTM 的患者，并结合国内外文献复习总结了该病的临床特征，以期为提高临床医生对该病的诊断意识提供参考。

Abstract：

As one of complications caused by tumor lung metastasis，pulmonary tumor thrombotic microangiopathy（PTTM）is rare but fatal，thus it is difficult to be diagnosed before the patient's death，with very poor prognosis. We shouldthink about the possibility of PTTM when found a patient performed as progressive dyspnea，dry cough，hypoxemia，elevationof D-dimer and FDP，pulmonary arterial hypertension without evidence of pulmonary embolism. This paper reported a clinicallydiagnosed patient with PTTM and summarized the clinical features of PTTM through reviewing literatures at home and abroad，inorder to provide a reference for improving the clinical diagnosis consciousness.

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