弥漫性大气道疾病4例临床总结  

Clinical analysis of diffuse large airway disease:a report of 4 cases

作　　者：黄爱本[1] 张杜超 庞莉[1] 钱进[1] 张振宁[1] 孙越[1] 潘磊[1] HUANG Aiben;ZHANG Duchao;PANG Li;QIAN Jin;ZHANG Zhenning;SUN Yue;PAN Lei(Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院,北京100038

出　　处：《实用医学杂志》2020年第17期2452-2456,共5页The Journal of Practical Medicine

基　　金：北京市科技计划课题(首都特色项目)(编号:2018-A20)。

摘　　要：目的探讨引起弥漫性大气道疾病的骨化性气管支气管病(tracheobronchopathia osteochondroplastica,TO)、复发性多软骨炎(relapsing polychondritis,RP)、气管支气管淀粉样变(tracheobronchial amyloidosis,TBA)、结节病的临床特征,以便早期诊断该类疾病。方法回顾性分析2010年8月至2019年5月首都医科大学附属北京世纪坛医院收治的4例弥漫性大气道疾病患者的病例资料,并复习文献。结果TO、RP、TBA及结节病各1例,其临床症状及体征无特异性。TO及结节病肺功能可正常,而RP、TBA常存在通气功能障碍。大部分TO、RP及TBA胸部CT可发现弥漫性大气道病变,而结节病胸部CT较少发现大气道异常。大部分患者气管镜检查有阳性发现,联合病理学有助于早期诊断。TO、结节病预后良好,而RP、TBA预后较差。结论应用肺功能-影像-气管镜-病理相结合的方法,可早期诊断弥漫性大气道疾病。Objective To explore the clinical characteristics of tracheobronchopathia osteochondroplastica(TO),relapsing polychondritis(RP),tracheobronchial amyloidosis(TBA)and sarcoidosis,which caused diffuseairway disease,in order to diagnose these diseases early.MethodsA retrospective analysis was performed on thedata of 4 cases of diffuse airway disease admitted to Beijing Shijitan Hospital affiliated to Capital MedicalUniversity from August 2010 to May 2019,and the relevant literatures were reviewed.ResultsThere was nospecial symptom and physical sign in the patients of TO(1 case),RP(1 case),TBA(1 case)and sarcoidosis(1 case).TO and sarcoidosis spirometry could be normal,but RP,TBA often had ventilation dysfunction.Chest CTof most patients with TO,RP and TBA could indicate diffuse airway lesions,while sarcoidosis rarely showedabnormalities.Most patients had positive findings on bronchoscopy.Bronchoscopy combined with pathologicalexamination was helpful for the early diagnosis of these diseases.Patients with TO and sarcoidosis had a goodprognosis,while those with RP and TBA had a poor prognosis.ConclusionThe combination of spirometry-imaging-bronchoscope-pathology can be used to diagnosis diffuse airway disease early.

关 键 词：骨化性气管支气管病 复发性多软骨炎 气管支气管淀粉样变 结节病 

分 类 号：R562[医药卫生—呼吸系统]