单纯性支气管内膜结核肺功能改变及其特点

目的探讨单纯性支气管内膜结核(EBTB)患者的肺功能改变及其特点,提高对单纯性EBTB的认识。方法分析2000～2005年收治的18例单纯性EBTB患者的肺功能及其流量-容积(V-V)曲线改变特点;选取同期健康体检者18名作为正常对照组,进行两组间比较。结果(1)单纯性EBTB组患者肺活量(VC)、用力肺活量(FVC)分别为3.10±1.00、2.91±1.01,与正常对照组3.40±0.51、3.30±0.58比较差异均无统计学意义(t=1.117、1.400,均P>0.05);单纯性EBTB组第1秒用力呼气容积(FEV1)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)分别为1.93±0.65、68.4±19.0,较正常对照组2.71±0.66、84.1±21.0低(P<0.05);(2)单纯性EBTB患者78%存在通气功能障碍,33%患者表现为阻塞性通气功能障碍,28%患者表现为限制性通气功能障碍,17%患者存在混合性通气功能障碍;(3)对表现为阻塞性或混合性通气功能障碍者进行支气管舒张试验,阳性率为44%;(4)存在通气功能障碍的单纯性EBTB患者,其V-V曲线形态具有一定的特征。结论大多数EBTB患者存在肺功能损害,以阻塞性通气障碍为主,支气管舒张试验大多阴性,但也可阳性,V-V曲线形态有时有一定特征性改变。

The alternation of lung function in patients with simple endobronchial tuberculosis

Objective To investigate the lung function in patients with simple endobronchial tuberculosis(EBTB).Methods The lung function tests were performed in 18 patients with simple EBTB(simple EBTB group)and 18 healthy controls(control group).Results There were no statistical differences of VC and FVC between simple EBTB group and control group;FEV1,FEV1/FVC in simple EBTB group were significantly lower than those in control group.14 cases in simple EBTB group(78%)showed abnormal ventilatory function,6 cases(33%)demonstrated obstructive ventilatory function disturbance,5 cases(28%)had restricted ventilatory function disturbance,and 3 cases(17%)had mixed ventilatory function disturbance.9 cases in simple EBTB group with obstructive or mixed ventilatory function disturbance received brochodilation test,and 4 cases(44%)were positive.Some patients in simple EBTB group who had abnormal ventilatory function had characteristic changes in flow-volume curve.Conclusion Most patients with simple EBTB have abnormal ventilatory function,mainly obstructive ventilatory function disturbance,brochodilation test may be positive and sometimes flow-volume curve has characteristic changes.