發(fā)布時間：2018-08-15 11:53

【摘要】：目的總結(jié)彌漫性泛細支氣管炎(DPB)患者的臨床特征,增強對DPB的臨床特點認識,以期早期診斷和及時治療。方法回顧性分析1996年12月至2014年7月在北京協(xié)和醫(yī)院住院確診的35例DPB患者的臨床資料,DPB診斷符合日本厚生省1998年第2次修訂的DPB臨床診斷標準或組織病理學標準。結(jié)果 35例DPB患者中,男性20例(57.1%)、女性15例(42.9%),男女比例為1.33∶1;平均年齡(42.2±15.6)歲,主要分布在40~49歲;平均病史(8.4±8.5)年。35例(100%)均出現(xiàn)慢性咳嗽,31例(88.6%)有較多膿痰,24例(68.6%)出現(xiàn)勞力性呼吸困難,28例(80.0%)肺部可聞及吸氣末爆裂音,26例(74.3%)有鼻竇炎病史,15例檢測血凝集素實驗者均為陰性,22例(73.3%)痰培養(yǎng)中可見銅綠假單胞菌、流感嗜血桿菌等G-細菌,26例(83.9%)血氣分析出現(xiàn)低氧血癥,患者的第1秒末用力呼氣量/用力肺活量、殘氣量/肺總量、50%肺活量時最大用力呼氣流量、25%肺活量時最大用力呼氣流量的均值分別為60.5%、53.8%、25.9%、31.2%,胸部CT主要表現(xiàn)為肺部彌漫性小葉中心性微結(jié)節(jié)和支氣管擴張,29例(82.9%)曾被誤診為肺部感染、支氣管擴張等疾病。結(jié)論國內(nèi)的DPB與日本有不一樣的特征:血凝集素實驗多為陰性,且痰病原體構(gòu)成譜不一致。DPB常被誤診,對于反復出現(xiàn)肺部感染且合并鼻竇炎的患者,應高度警惕DPB。
[Abstract]:Objective to summarize the clinical features of patients with diffuse panbronchiolitis (DPB) and to enhance the understanding of the clinical features of DPB in order to diagnose and treat in time. Methods the clinical data of 35 DPB patients who were hospitalized in Peking Union Hospital from December 1996 to July 2014 were analyzed retrospectively. The diagnosis of dpb was in accordance with the second revised DPB clinical diagnostic criteria or histopathological criteria of Japan's Ministry of Health and Health in 1998. Results among the 35 DPB patients, 20 were male (57.1%), 15 were female (42.9%), the ratio of male to female was 1.33: 1, the average age was (42.2 鹵15.6) years old, mainly distributed in 400-49 years old. The mean history was (8.4 鹵8.5) years. 35 cases (100%) had chronic cough. 31 cases (88.6%) had chronic cough. 24 cases (68.6%) had more pus phlegm, 28 cases (80.0%) had laborious dyspnea, 26 cases (74.3%) had a history of nasal sinus disease and 26 cases (74.3%) had a history of nasal sinusitis, 28 cases (80.0%) had pulmonary dyspnea and 26 cases (74.3%) had a history of nasosinusitis. Pseudomonas aeruginosa was found in 22 cases (73.3%) of sputum culture. Haemophilus influenzae and other G-bacteria (83.9%) showed hypoxemia in blood gas analysis. Forced expiratory volume / forced vital capacity at the end of the first second was observed in 26 patients. The mean value of maximum forced expiratory flow at 50% vital capacity and 25% vital capacity was 60.5% 53.8% and 25.9%, respectively. The main CT manifestations were diffuse lobular central microtubercle and bronchiectasis in 29 cases (82.9%). Was misdiagnosed as a lung infection, Bronchiectasis, etc. Conclusion DPB in China is different from that in Japan: hemagglutinin test is negative and sputum pathogen composition spectrum is inconsistent. Dpb is often misdiagnosed. The patients with recurrent pulmonary infection and sinusitis should be on high alert.
【作者單位】： 中國醫(yī)學科學院北京協(xié)和醫(yī)學院北京協(xié)和醫(yī)院呼吸內(nèi)科;
【基金】：國家自然科學基金(81170040,81470229) 國家科技支撐計劃(2012BAI05B00)~~
【分類號】：R562.21

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9 劉t，

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