中国人弥漫性泛细支气管炎45例临床总结  

Analysis of 45 Patients with Diffuse Panbronchiolitis in China

作　　者：刘淼冰[1] 丁可[1] 吴金玲[1] 马惠清[1] 方向阳[1] 缪国斌[1] 张麟[1] 

机构地区：[1]首都医科大学附属北京朝阳医院综合科,北京100020

出　　处：《中国医刊》2006年第11期39-40,共2页Chinese Journal of Medicine

摘　　要：目的 通过回顾我国报道的病例，以提高对弥漫性泛细支气管炎（DPB）的认识。方法 使用Medline和CHKD期刊全文数据库，检索自1996—2005年7月我国报道的病例并进行总结。结果 ①45例患者中，男性与女性比例约为2：1，发病年龄45，2±16，3岁，病例分布全国各地；②几乎所有患者均有咳嗽、咳痰、气促症状，大多数患者肺部可闻及湿啰音；③多数病例胸片即能发现小结节影，胸部CT和（或）高分辨CT表现为典型的弥漫或散在分布的小叶中心性结节影，62，2％的病例伴有支气管扩张；④痰菌培养铜绿假单胞菌检出率最高；⑤冷凝集试验≥1：64占74，3％；⑥HLABW5阳性率58．3％；⑦92．5％的病例呈阻塞性通气功能障碍；⑧误诊率高，经支气管肺活检阳性率高；⑨95，6％的病例描述了鼻窦炎病史和（或）副鼻窦影像学结果，100％显示阳性；（10）使用大环类脂类抗生素治疗效果显著。结论 DPB在我国可能不少见，但误诊率极高；大环类酯类抗生素能显著改善患者预后；迫切需要我国临床医师提高对该病的认识及诊治水平。Objective To improve the identification of diffuse panbronchiolitis （DPB）. Methods To analyze 45 cases of DPB reported in China's Mainland from 1996 to 2005 which were obtained through searching MDLINE and CHKD. Resuits The 45 patients （31 males and 14 females） were distributed in 16 provinces. The average age of onset was 45.2, ranging from 28.9 to 61.5. Almost all the patients presented with chronic cough, sputum production, and dyspnea. CXR showed diffuse fine nodular shadows in 84.4% patients and computer tomogram revealed typical centrilobular nodules in all the patients, in which 28 cases were accompanied by bronchiectasis. Pseudomonas aeruginosa were found in 19 cases. Cold agglutination test was positive in 64.4% cases. 95.6% patients had the history and X-ray manifestation of sinusitis . Pulmonary function test showed obstructive dysfunction in 92.5% cases. Human leukocyte antigen-BW54 was positive in 58.3% patients. 43 patients had been misdiagnosed before the diagnosis of DPB was made. Transbronchial lung biopsy could help to establish the diagnosis. Macrolides could significantly improve the prognosis. Conclusion DPB is not rare in China. The features of Chinese patients resemble those described in Japanese patients. Macrolides could significantly improve the prognosis. Physicians should enhance their awareness of DPB so that the disease can be recognized and treated earlier.

关 键 词：弥漫性泛细支气管炎 大环类脂类抗生素 中国 

分 类 号：R563.1[医药卫生—呼吸系统]