支气管炭末样色素纤维化的支气管超声影像学特点  

Bronchial ultrasound imaging features of bronchial anthracofibrosis

作　　者：周国旗 刘代顺[2] 王蕾 陆小凤 蔡小燕 曾庆松 邹丽 朱婷婷 罗先跃 Zhou Guoqi;Liu Daishun;Wang Lei;Lu Xiaofeng;Cai Xiaoyan;Zeng Qingsong;Zou Li;Zhu Tingting;Luo Xianyue(Department of Respiratory and Critical Care Medicine,People’s Hospital of Honghuagang District;Department of Respiratory and Critical Care Medicine,The First People’s Hospital of Zunyi;Department of Respiratory and Critical Care Medicine,Rizhao Hospital of Traditional Chinese Medicine)

机构地区：[1]遵义市红花岗区人民医院呼吸与危重症医学科,遵义563003 [2]遵义市第一人民医院呼吸与危重症医学科,遵义563000 [3]日照市中医院呼吸与危重症医学科,日照276800

出　　处：《重庆医科大学学报》2022年第4期463-468,共6页Journal of Chongqing Medical University

基　　金：遵义市科技局合作资助项目(编号:社字[2018]251号);红花岗区呼吸与危重症医学人才基地资助项目(编号:[2020]5号);遵义市科技局合作资助项目(编号:社字[2017]54号)。

摘　　要：目的:观察支气管炭末样色素纤维化(bronchial anthracofibrosis,BAF)患者支气管超声影像学特点,为该疾病防治提供有效的临床线索。方法:从2018年4月至2019年10月于遵义市红花岗区人民医院呼吸与危重症医学科行气管镜检查及治疗的患者1243例中选取BAF患者113例作为研究对象。BAF患者根据镜下分为扁平型31例,深部缩回型38例以及黏膜突起型44例。除黑色病变外,统计镜下病变情况(如支气管肿胀、支气管闭塞等)。利用超声小探头对段、亚段支气管行影像学检查,分析最大管壁及黏膜下层厚度,对比各亚型BAF管壁黏膜下层及骨性组织面积的平均值。结果:BAF组有结核病史的患者13例(占11.5%),另外,BAF组有生物燃料暴露的患者57例(占50.4%),平均暴露时间(17.4±6.2)年;BAF发病率占本院气管镜检查总数的10%。利用Image J 18.0将BAF各亚组气道放大后测量管壁各项指标发现,深部缩回型[(17.3±5.7)mm]和黑色突起型[(19.3±5.4)mm]管壁最大厚度较扁平组[(12.5±5.0)mm]明显增加,差异具有统计学意义(P<0.05);深部缩回型[(9.8±3.0)mm]和黑色突起型[(14.5±5.0)mm]黏膜下层最大厚度较扁平型[(6.6±3.5)mm]明显增加(P<0.05);扁平型BAF组与黑色突起型的骨性组织面积比分别为(33.3±9.3)%和(34.9±12.1)%,较深部缩回型[(65.2±8.7)%]明显减少(P<0.05),黑色突起型为(34.9±12.1)%,较扁平型无明显变化(P>0.05)。结论:BAF患者远端气道存在异常超声影像学特点,并且不同亚型BAF气道黏膜结构及骨性声像存在差异,由此推测支气管超声影像和气道壁结构分析可能成为不同亚型BAF诊断的重要参考指标。同时,这也为了解远端气道的特点提供了临床线索。Objective:To observe the characteristics of bronchial ultrasound imaging in patients with bronchial anthracofibrosis(BAF and provide effective clinical clues for the prevention and treatment of the disease.Methods:From April 2018 to October 2019,113patients with BAF who underwent bronchoscopy and treatment in the Department of Respiratory and Critical Care Medicine of People’s Hospital of Honghuagang District,Zunyi were selected as the research objects.BAF patients were classified into 31 cases of flat type,38 cases of deep retraction type,and 44 cases of mucosal protrusion type under the microscope.Except for black lesions,the lesions under microscope were statistically counted,such as bronchial swelling,bronchial occlusion,etc.The segmental and sub-segmental bronchus were examined by ultrasound with a small ultrasound probe to analyze the maximum tube wall and submucosal thickness,and to compare the average of the submucosal and bony tissue area of each subtype of BAF.Results:In this study,13 patients(11.5%)had a history of tuberculosis in the BAF group.In addition,57 patients(50.4%)were exposed to biofuels in the BAF group.The average exposure time was(17.4±6.2)years,and the incidence of BAF accounted for10%of the total number of bronchoscopy in our hospital.Using Image J 18.0 to magnify the airways of each BAF subgroup and measure the various indicators of the tube wall,it was found that the maximum wall thickness of the deep retracted type[(17.3±5.7)mm]and the black protruding type[(19.3±5.4)mm]was significantly higher than that of the flat group[(12.5±5.0)mm],with statistically significant differences(P<0.05).The maximum thickness of the submucosa of the deep retracted type[(9.8±3.0)mm]and the black protruding type[(14.5±5.0)mm]was significantly increased compared with the flat type[(6.6±3.5)mm](P<0.05).The area ratio of the bone tissue between the flat BAF group and the black protrusion type was(33.3±9.3)%and(34.9±12.1)%,which was significantly reduced than that of the deep retracted type[(65.2�

关 键 词：支气管炭末样色素沉着症 支气管超声影像 

分 类 号：R562[医药卫生—呼吸系统]