536例右中叶综合征病因分析

Etiological analysis of 536 cases of the right middle lobe syndrome

目的 探讨右中叶综合征的病因分布规律。方法 回顾性分析536例临床诊断右中叶综合征患者的纤维支气管镜（纤支镜）检查结果，并按年龄、吸烟状况等分组进行比较。结果 病因组成中炎症占67.7%，肿瘤占18.3%，结核占9.0%。炎症在青年组和中年组间有显著差异（P均〈0.05）；结核在青年组和中年组间、青年组和老年组间均有显著差异（P均〈0.05）。炎症、肿瘤和结核在不吸烟组与重度吸烟组（≥400年支）间，肿瘤和结核在不吸烟组和中度吸烟组（100-400年支）间均有显著差异（P均〈0.05）。结论 纤支镜检查发现右中叶综合征最常见的病因依次为炎症、肿瘤和结核，对于年龄〉40岁和吸烟≥400年支的患者应高度警惕罹患癌症的可能。纤支镜检查对于明确右中叶综合征的病因有不可替代的作用和较高的应用价值。

Objective To explore the etiology of right middle lobe syndrome. Methods The resuhs of fiberoptic bronchoscopy of 536 patients who were clinically diagnosed as right middle lobe syndrome were analyzed retrospectively, The differences of the causes distribution were compared between different age groups and smoking status groups. Results The leading causes of right middle lobe syndrome were inflammation （67.7 % ）, tumor（ 18.3 % ） and tuberculosis（9.0 % ）. The distribution differences of inflammation between youth and middle-age groups, of tumor between youth, middle-age and elder groups, and of tuberculosis between youth and middle-age groups, youth and elder groups were all significant（all P 〈 0.05）, The distribution differences of inflammation, tubereulosis and tumor between non-smokers and heavy-smokers, of tuberculosis and tumor between non-smokers and moderate-smokers were also significant（all P 〈 0.05）. Conclusions The most common causes of middle lobe syndrome are inflammation, tumor and tuberculosis. Patients over 40 years old and with a smoking history of ≥ 400 cigarette-years should be alerted for tumor. Fiberoptic bronchoscopy is a unique approach for exploring the causes of right middle lobe syndrome.