摘要
目的探讨结核性气道狭窄的临床特点。方法收集广东省4个医疗中心1年内确诊的气管支气管结核(TBTB)患者,分析其气道狭窄发生率、危险因素及支气管镜下特点。并对不同性别的气道狭窄部位、病变类型等进行比较。结果共确诊TBTB患者345例,其中合并气道狭窄206例,狭窄发生率为59.7%。狭窄以上叶居多(50.0%),单侧累及为主,左侧多于右侧(53.9%比44.2%)。重度气道狭窄49例(23.8%),左、右侧分别为49.0%、51.0%,其中左侧主要累及上叶(37.5%)、主支气管(37.5%),右侧主要累及上叶(44.0%)、中叶及中间段支气管(40.0%)。在TBTB患者中,女性、年龄≥18岁、不吸烟者、有症状到就诊时间≥4周的患者有较高的气道狭窄发生率(P<0.05)。气道狭窄患者在不同性别间的差异:女性气道狭窄患者的中位年龄小于男性(31岁比43岁,P<0.05);女性气道狭窄较易累及左侧及双肺主支气管,且溃疡坏死型多于男性(P<0.05)。结论TBTB合并气道狭窄较易发生在中青年女性,且不同性别其狭窄发生部位及病变类型有明显差异。
Objective To investigate the clinical characteristics of tracheobronchial stenosis due to tracheobronchial tuberculosis(TBTB).Methods We recruited all patients diagnosed as TBTB within one year from four centers of Guangdong province,southern China.The prevalence,risk factors and bronchoscopy characteristics of tracheobronchial stenosis were analyzed.The location and pathological type of stenosis were also compared between different genders.Results A total of 345 patients were diagnosed with TBTB,206 cases(59.7%)of which were concomitant with varying degrees of tracheobronchial stenosis.The stenosis was mainly located at upper lobe(50.0%)and gave priority to unilateral infiltration.The proportion of left and right-side stenosis were 53.9%and 44.2%,respectively.Forty-nine cases(23.8%)with tracheobronchia stenosis developed severe airway narrowing,the proportion of which was similar between left and right-side lung(49%vs.51%).Severe stenosis in the left-side lung mainly involved in upper lobe(37.5%),main bronchus(37.5%)and the right-side mainly involved in upper lobe(44.0%),middle lobe or intermediate bronchus(40.0%).Among the TBTB patients,females,those with age≥18 years,non-smokers,and those with symptom duration≥4 weeks were more likely to be with tracheobronchial stenosis(P<0.05).The differences in gender between the patients with airway stenosis were as follows:the median age of female tracheobronchial stenosis patients was smaller than that of male patients(31 years vs.43 years,P<0.05);stenosis were more likely involved in left side and main bronchus in female patients;ulceration necrosis of stenosis was more frequently seen in the female patients(P<0.05).Conclusions Tracheobronchial stenosis due to tracheobronchial tuberculosis is more frequently seen in young and middle-aged female patients.There are different stenosis location and lesion types between different genders.
作者
程砚秋子
苏柱泉
吴智龙
张培泽
陈伟生
周子青
罗为展
郭文亮
陈小波
孙婉
李时悦
CHENG Yanqiuzi;SU Zhuquan;WU Zhilong;ZHANG Peize;CHEN Weisheng;ZHOU Ziqing;LUO Weizhan;GUO Wenliang;CHEN Xiaobo;SUN Wan;LI Shiyue(Department of Respiratory Medicine,State Key Laboratory of Respiratory Disease,Guangzhou Institute of Respiratory Disease,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong 510120,P.R.China;Department of Tuberculosis,The Fourth People’s Hospital of Foshan,Foshan,Guangdong 528041,P.R.China;Second Department of Respiratory Medicine,The Third People’s Hospital of Shenzhen,Shenzhen,Guangdong 528041,P.R.China;Department of Tuberculosis,The Third People’s Hospital of Shantou,Shantou,Guangdong 515073,P.R.China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2020年第4期379-383,共5页
Chinese Journal of Respiratory and Critical Care Medicine
基金
国家自然科学基金面上项目(81770017)。
关键词
气管支气管结核
气道狭窄
临床特点
Tracheobronchial tuberculosis
Tracheobronchial stenosis
Clinical characteristics
