合并气管-支气管炎的复发性多软骨炎诊治分析  

Analysis of clinical diagnosis and treatment of relapsing polychondritis complicated with trachitis and bronchitis

作　　者：何馨[1] 吴艳军[1] 徐波[1] 杨霭琳 王浩彦[1] 姚志刚[1] HE Xin;WU Yanjun;XU Bo;YANG Ailin;WANG Haoyan;YAO Zhigan(Department of Respiratory Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院呼吸内科,100050

出　　处：《心肺血管病杂志》2024年第11期1148-1154,共7页Journal of Cardiovascular and Pulmonary Diseases

基　　金：国家自然科学基金(81870029,82000042);北京市临床重点专科建设项目(2020-2022);北京市通州区科技计划项目(KJ2023CX018)。

摘　　要：目的:归纳和探讨复发性多软骨炎(relapsing polychondritis,RP)合并气管-支气管炎患者临床特点及诊疗方法,提高临床医师对该疾病的诊疗能力。方法:回顾性收集首都医科大学附属北京友谊医院收治的RP合并气管-支气管炎患者的基本资料、临床表现、影像学检查、诊疗过程等临床资料,分析和讨论该疾病的临床特点。结果:共收集RP合并气管-支气管炎患者5例,均为女性,平均年龄(59.8±8.6)岁。临床表现主要为咳嗽、咳痰、发热、胸闷、关节痛及下肢水肿。肺部体征包括呼吸音增粗、湿性啰音及干性啰音。胸部CT表现包括气管支气管管壁增厚、管腔狭窄、气管壁钙化及肺不张。病原学检查结果包括革兰阴性菌、克柔念珠菌、肺炎支原体、白色念珠菌。明确发病原因后积极给予针对性抗感染、化痰等治疗后,患者均好转出院。结论:RP患者呼吸道症状加重可能为疾病进展导致,也可能由气管-支气管炎导致,及早发现病因并及时给予针对性治疗,可以减少激素及免疫抑制药物的剂量,显著改善患者症状。Objective:To summarize and discuss the clinical characteristics,diagnosis,and treatment of relapsing polychondritis(RP)patients complicated with trachitis and bronchitis,in order to improve the diagnosis and treatment ability of clinicians for this disease.Methods:The basic data,clinical manifestations,imaging examination,diagnosis,and treatment process of RP patients with trachitis and bronchitis admitted to Beijing Friendship Hospital,Capital Medical University were retrospectively collected,and the clinical characteristics of the disease were analyzed and discussed.Results:A total of 5 patients with RP combined with trachitis and bronchitis were collected,all of whom were female,with an average age of(59.8±8.6)years.The main clinical manifestations were cough and sputum,fever,chest tightness,joint pain,and lower limb edema.The physical signs of lung include rough respiratory sounds,moist rales,and rhonchi.Chest CT showed thickening of tracheobronchial tube wall,tracheobronchial lumen stenosis,calcification of tracheobronchial tube wall and atelectasis.The results of the etiological examination include Gram-negative bacteria,Candida krusei,Mycoplasma pneumoniae and Candida albicans.After identifying the cause of the disease,the patients were actively given targeted anti-infection,phlegm reduction and other treatments.Eventually,all patients had remission of symptoms and were discharged.Conclusion:The aggravation of respiratory symptoms in RP patients may be caused by disease progression or trachitis and bronchitis.Early detection of the cause and timely targeted treatment can reduce the dose of hormones and immunosuppressive drugs and significantly improve the symptoms of patients.

关 键 词：复发性多软骨炎 气管-支气管炎 念珠菌感染 

分 类 号：R56[医药卫生—呼吸系统]