摘要
目的 总结弥漫性泛细支气管炎（diffuse panbronchiolitis,DPB）的临床特征,提高诊疗水平。方法 收集31例就诊于中国医科大学呼吸疾病研究所的DPB确诊病例,总结和分析其临床表现、影像学特征及其对红霉素治疗的反应。结果 31名患者均咳嗽、咳痰和/或呼吸困难,闻及湿罗音。平均用力呼气容积占预计值的百分比（FEV1%pred）为54.1%±11.2%,平均动脉血氧分压为（63±12.5） mmHg。31名患者均有慢性鼻窦炎。胸部CT均显示弥漫性小叶中心性分布小结节的24例（77.4%）伴树芽征;19例（61.3%）有周围性支气管扩张,其中12例（38.7%）伴中央性支气管扩张。13例（41.9%）患者有铜绿假单胞菌感染,其中3例有周围性支气管扩张,另外10例同时有中央性和周围性支气管扩张。经过3个月肠溶红霉素治疗后,平均FEV1%pred为67.5%±14.7% （t=2.451,P=0.036）,平均动脉血氧分压为（71.0±8.1） mmHg （t=2.153,P=0.029）,铜绿假单胞菌培养2例（χ2=4.65,P=0.031）。结论 慢性鼻窦炎和肺CT表现为弥漫性小叶中心性小结节伴树芽征和周围性支气管扩张是DPB的突出临床表现;红霉素可有效治疗该病。
Objective To analyze the clinical features of diffuse panbronchiolitis （DPB） in order to improve the ability to make an accurate diagnosis.Methods We retrospectively reviewed and evaluated the clinical presentations,radiologic characteristics and response to erythromycin therapy of thirtyone patients diagnosed as DPB in the institute of respiratory disease of China Medical University.Results All of the thirtyone patients had symptoms of productive cough and/or dyspnea,and coarse crackle on auscultation.The average FEV1/FVC was 54.1%±11.2%.The average PaO2 was （63±12.5） mmHg.All had chronic sinusitis.Diffuse centrilobular nodules were found on thoracic computed tomography of all patients with treeinbud pattern in 24 （77.4%） of them.Peripheral bronchiectasis was revealed in 19 cases （61.3%） with central bronchiectasis in 12 （38.7%） of them.Pseudomonas aeruginosa was isolated in 13 patients （41.9%）,3 of whom had peripheral bronchiectasis and 10 had both peripheral and central bronchiectasis.After 3 months of erythromycin therapy,the mean FEV1% pred was 67.5%±14.7% （t=2.451,P=0.031） and the mean PaO2 was （71.0±8.1） mmHg （t=2.153,P=0.029）,only 2 patients were isolated with pseudomonas aeruginosa in sputum （χ2=4.65,P=0.031）.Conclusions Chronic sinusitis and diffuse centrilobular nodularity with tree-in-bud pattern and bronchiectasis are the significant clinical features of diffuse panbronchiolitis.Erythromycin can effectively treat diffuse panbronchiolitis.
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2014年第3期357-361,共5页
Fudan University Journal of Medical Sciences
