弥漫性泛细支气管炎的诊治

目的探讨弥漫性泛细支气管炎（DPB）的临床特点及诊断方法。方法举例确诊为DPB患者的临床资料，并结合文献复习。结果DPB是一种以两肺弥漫性呼吸性细支气管及其周围的慢性炎症为特征的独立性疾病，临床表现为慢性咳嗽、咳痰、活动后呼吸困难，常合并铜绿假单胞菌感染和慢性鼻窦炎；胸部高分辨CT（HRCT）有助于诊断弥漫性泛细支气管炎，早期诊断及时给予大环内酯类药物规范化治疗，本病预后良好。结论对长期慢性咳嗽、咳痰，合并有慢性鼻窦炎病史的患者。应高度怀疑本病可能，应用小剂量红霉素或其他大环内酯类抗菌药物长期治疗，效果良好。

Diffuse panbronchiolitis and its clinical analysis

Objective To investigate the clinical features and diagnostic procedures for diffuse panbronehioliti, and to highlight the characteristics of diffuse panbronehiolitis （DPB） in community hospital. Methods One patient with DPB confirmed by clinic was described and relevant literatures were reviewed. Results DPB was an alone disease characterized by infltration of inflammatory cells around bronchioles. Symptoms included cough, expectoration, and dyspnea after exercises. Psoudomonas aetuginosa was isolated from sputum in some cases. Some patients had the history and X-ray manifestation of sinusitis. The reason for a high misdiagnosis rate was due to its clinical findings and its diagnosis standard among doctors in community hospital. Chest high resolution CT（HRCT） could be attributed to the diagnosis of diffus panbronehiolitis. The early,treatment with maerolides was satisfied. Conclusion The patients with the history of chronic cough. Expectoration and sinusitis should be diagnosed. Long term,low dose macrelide therapy may improve the prognosis through an antiinflammatory effect.