弥漫性泛细支气管炎12例临床分析  

Retrospective analysis of 12 patients with diffuse panbronchiolitis

作　　者：覃淑娟[1] 陈书平[1] 

机构地区：[1]贵港市人民医院呼吸内科,广西537100

出　　处：《中国临床新医学》2017年第6期546-549,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨弥漫性泛细支气管炎(DPB)的临床特征及红霉素治疗效果。方法回顾性分析2010-10~2015-06接受红霉素治疗的12例DPB患者的临床资料,包括临床症状及体征、影像学表现、实验室检测指标,观察红霉素治疗过程及结果。结果 12例DPB患者的平均发病年龄为(59.2±10.4)岁,从发病到确诊时间平均(9.3±7.4)年。12例胸部CT均表现为小叶中央性结节,12例肺功能均提示阻塞性通气功能障碍及血气分析提示低氧血症,1例冷凝集试验阳性。既往被误诊为慢性阻塞性肺疾病(COPD)6例,支气管哮喘1例,支气管扩张症4例,粟粒型肺结核1例。通过红霉素治疗,10例DPB患者临床症状改善;2例患者出现复发,经再次红霉素治疗后临床症状改善。结论 DPB易被误诊,应提高对其认识。红霉素治疗DPB有效,患者耐受性好。Objective To investigate the clinical features and the efficacy of erythromycin on the patients with diffuse panbronchiolitis（DPB）. Methods 12 patients with DPB who were treated with erythromycin from Octo- ber 2010 to June 2015 were retrospectively analyzed. The clinical effects, radiological results, and laboratory parame- ters were analyzed, and the treatment course and the outcome of the treatment were recorded. Results The mean age of the 12 patiens at symptom onset was （59. 2 ±10.4）years, and the time from symptom onset to a correct diagnosis was （9. 3 ± 7.4）years. Chest computed tomography showed centrilobularmicronodules in 12 cases. Lung function test showed obstructive ventilator impairment in 12 cases and artery blood gas analysis showed hypoxemia in 12 cases. An elevated cold agglutinin titer was found in 1 case. 6 cases were misdiagnosed as COPD; 1 case was misdiagnosed as bronchial asthma; 4 cases were misdiagnosed as bronchiectasis and 1 case was misdiagnosed as mihary pulmonary tu- berculosis. After the treatment of erythromycin, the clinical symptoms were improved in 10 cases, and 2 patients had a relapse and clinically improved after a second course of erythromycin treatment. Conclusion DPB is apt to be mis- diagnosed and should be paid more attention. Erythromycin is effective and well tolerated for the patients with diffuse panbronchiolitis.

关 键 词：红霉素 弥漫性泛细支气管炎 临床特征 

分 类 号：R56[医药卫生—呼吸系统]