6例儿童弥漫性泛细支气管炎的临床分析  

Clinical analysis of 6 cases of diffuse panbronchiolitis in children

作　　者：邓丽欣 陈德晖[2] 林育能[2] 吴上志[2] 徐佳兴[2] 黄展航 顾莹莹[3] 冯俊翔 DENG Li-Xin;CHEN De-Hui;LIN Yu-Neng;WU Shang-Zhi;XU Jia-Xing;HUANG Zhan-Hang;GU Ying-Ying;FENG Jun-Xiang(Department of Pediatrics,The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China)

机构地区：[1]广州市花都区人民医院儿科,广东广州510800 [2]广州医科大学附属第一医院儿科,广东广州510120 [3]广州医科大学附属第一医院呼吸病理中心,广东广州510120 [4]广州医科大学附属第一医院放射科,广东广州510120

出　　处：《中国当代儿科杂志》2025年第3期334-339,共6页Chinese Journal of Contemporary Pediatrics

基　　金：广东省基础与应用基础研究基金(省企联合基金)(2021A1515220043)。

摘　　要：目的分析儿童弥漫性泛细支气管炎(diffuse panbronchiolitis,DPB)的临床特点,以提高该病的临床诊疗水平。方法回顾性分析2011年1月—2019年12月在广州医科大学附属第一医院住院诊断为DPB的6例患儿的临床资料。结果6例患儿中,男2例,女4例;诊断年龄为7~12岁。所有患儿均有咳嗽、咳痰、活动后气促症状,均有鼻窦炎史。2例血清冷凝集试验阳性,5例可见慢性细支气管炎的病理改变,6例胸部高分辨率CT见双肺弥漫分布小叶中心性结节并见“树芽征”。5例患儿予小剂量阿奇霉素维持治疗,3例治疗效果不佳,经验性抗结核治疗后肺泡灌洗液中发现非结核分枝杆菌。随访2年,治愈1例,明显好转3例,部分好转2例。结论DPB临床表现非特异性,极易误诊。对于临床诊断DPB明确,而小剂量阿奇霉素干预治疗无改善者,需要考虑特殊感染。Objective To analyze the clinical characteristics of diffuse panbronchiolitis(DPB)in children and to enhance the clinical diagnosis and treatment of this disease.Methods A retrospective analysis was conducted on the clinical data of 6 children diagnosed with DPB who were hospitalized at The First Affiliated Hospital of Guangzhou Medical University from January 2011 to December 2019.Results Among the 6 patients,there were 2 males and 4 females;the age at diagnosis ranged from 7 to 12 years.All patients presented with cough,sputum production,and exertional dyspnea,and all had a history of sinusitis.Two cases showed positive serum cold agglutinin tests,and 5 cases exhibited pathological changes consistent with chronic bronchiolitis.High-resolution chest CT in all patients revealed centrilobular nodules diffusely distributed throughout both lungs with a tree-in-bud appearance.Five patients received low-dose azithromycin maintenance therapy,but 3 showed inadequate treatment response.After empirical anti-tuberculosis treatment,non-tuberculous Mycobacteria were found in the bronchoalveolar lavage fluid.Follow-up over 2 years showed 1 case cured,3 cases significantly improved,and 2 cases partially improved.Conclusions The clinical presentation of DPB is non-specific and can easily lead to misdiagnosis.In cases where DPB is clinically diagnosed but does not show improvement with low-dose azithromycin treatment,special infections should be considered.

关 键 词：弥漫性泛细支气管炎 诊断 非结核分枝杆菌 儿童 

分 类 号：R725.6[医药卫生—儿科]