弥漫性泛细支气管炎18例诊治分析

目的:探讨弥漫性泛细支气管炎(diffuse panbronchiolitis,DPB)的临床特征、诊断和治疗。方法:回顾分析18例DPB患者的临床资料,分析其临床特点、误诊原因。结果:DPB患者的临床特征:(1)反复咳嗽、咳痰及活动时气促,部分患者有低热、盗汗;(2)胸部影像学:两肺弥漫性小叶中心性颗粒样结节状阴影,多合并有支气管扩张;(3)阻塞性通气功能障碍、低氧血症;(4)合并慢性鼻窦炎或既往有鼻窦炎病史;(5)常被误诊为肺结核、慢性支气管炎和支气管扩张;(6)经大环内酯类药物治疗后,患者临床症状明显改善。结论:了解DPB特异性的临床特征有助于做出正确的诊断。

Retrospective Study of 18 Patients with Diffuse Panbronchiolitis

Objective： To investigate the clinical characteristics, diagnosis and treatment of diffuse panbronchiolitis （DPB）. Methods：The clinical data of 18 patients with DPB was analyzed retrospectively to study the clinical features and causes of mis- diagnosis. Results： Patients with DPB had the following clinical characteristics. （1）The patients had repeatedly cough,sputum and shortness of breath. Some patients had low thermal and night sweats. （2）Chest imaging showed small diffuse centrilobular nodular shadows all over the lung, often accompanied with bronchiectasis. （3）Pulmonary function and blood gas analysis re vealed obstructive ventilatory dysfunction,hypoxemia. （4）Most of the patients had chronic sinusitis or the history of sinusitis. （5） Most of them had been misdiagnosed as pulmonary tuberculosis, chronic bronchitis and bronchiectasis. （6）After regular ma- crolide treatment,their clinical symptoms were improved significantly. Conclusions： The special clinical characteristics of DPB are crucial for the correct diagnosis.