急性白血病的肺部并发症有白血病细胞浸润肺实质,感染,血小板减少引起的出血,药物和放射性肺炎以及肺血管白细胞淤积(PL),发生率高达35%,然而患者死前的呼吸系统症状很少归咎于PL。本文报告4例ANLL患者并发PL引起的呼吸窘迫症。 4例患者中男1例、女3例,年龄26～69岁。外周血白细胞计数均高于20万,原始细胞大于70%。外周血和骨髓形态学所见证实为ANLL。入院时全部患者肺检查、胸X线摄片均正常。但开始化疗后10～48小时出现呼吸窘迫症,其临床表现为发热、呼吸困难、心动过速、弥漫性肺部罗音、胸膜渗出和严重低氧血症。胸部X片示弥漫性浸润、血管充血、心脏扩大和 Pulmonary complications of acute leukemia are leukemia cells infiltrating lung parenchyma, infection, thrombocytopenia-induced bleeding, drug and radiation pneumonitis, and pulmonary vascular leukocyte accumulation (PL) in up to 35% of cases, however, before the patient’s respiratory symptoms Less blame PL. This article reports 4 cases of ANLL patients complicated with PL-induced respiratory distress syndrome. 4 patients in 1 males and 3 females, aged 26 to 69 years. Peripheral blood leukocyte counts were higher than 200,000, more than 70% of the original cells. Peripheral blood and bone marrow morphology confirmed as ANLL. All patients admitted to the hospital lung examination, chest X-ray were normal. However, respiratory distress syndrome occurs 10 to 48 hours after the start of chemotherapy, with clinical manifestations of fever, dyspnea, tachycardia, diffuse pulmonary rales, pleural exudation, and severe hypoxemia. Chest radiograph showed diffuse infiltration, vascular congestion, heart enlargement and