支气管结核误诊为哮喘的原因分析和诊断方法探讨

目的探讨支气管结核误诊为哮喘的原因及其正确诊断的方法。方法对误诊为哮喘的24例支气管结核患者的临床资料进行分析。结果临床特征以刺激性咳嗽为主（91．7％），其次是活动后胸闷气促、肺部哮鸣音，胸部影像学无特征性。10例（41．7％）患者轻至中度的阻塞性或混合性通气功能障碍，其中4例支气管舒张试验阳性（16．7％）；支气管镜下表现为炎性浸润型58．3％，溃疡及干酪坏死型8．3％，肉芽增殖型12．5％，瘢痕狭窄型20．9％；病变部位最常见左主支气管和左上叶支气管，多部位受累占87．5％；支气管镜活检诊断11例（45．8％），刷检抗酸杆菌阳性13例（54．2％），支气管镜检后痰抗酸杆菌阳性14例（58．3％）。结论结核中毒症状不明显，而主要表现为喘鸣、咳嗽及胸闷的支气管结核患者，易于被误诊为哮喘，支气管镜检查是鉴别诊断的重要方法。

Reasons and methods of definite diagnosis on endobronchial tuberculosis misdiagnosed as asthma

Objective To explore the reasons and diagnostic methods on endobronchial tuberculosis misdiagnosed as asthma.Methods We conducted a retrospective analysis of 24 cases of endobronchial tuberculosis misdiagnosed as asthma.Results Activated cough was the most common clinical feature in 91.7%,and the others were exertional dyspnea and wheezing sound.Chest roentgenographic presentations were non-specific. 10 cases were presented with mild to moderate obstructive or mixed ventilation dysfunction (41.7%),and the p...