经纤维支气管镜肺活检对弥漫性间质性肺疾病的诊断价值

Diagnosis value of transbronchial lung biopsy in diffuse interstitial lung diseases

目的探讨经纤维支气管镜肺活检(TBLB)对弥漫性间质性肺疾病(D ILD)的诊断价值。方法报道168例D ILD患者,其中行TBLB病理检查确诊45例(26.79%),分析患者性别、病理诊断构成比及误诊情况等。结果 45例患者中,误诊为非特异性肺炎8例,肺结核6例,肺癌5例,肺淋巴瘤4例,肺动脉高压3例,气道中心纤维化2例;女性患者明显多于男性(27 vs 18,P<0.01)。D ILD患者中特发性间质性肺炎最多(32例),其次是结缔组织病相关D ILD(8例)、结节病(5例)。结论 TBLB是诊断D ILD的有效手段,对D ILD的鉴别诊断和分类诊断有重要意义。

Objective To evaluate the diagnostic value of transbronchial lung biopsy（TBLB） on diffuse interstitial lung disease（DILD）.Methods A total of 168 patients with DILD was reported.Confirmed diagnosis by TBLB was obtained in 45 patients（26.79%）,The patient′s sex,composition ratio of pathological diagnosis,the rates of diagnosis and misdiagnosis were retrospectively analyzed.Results A total of 45 patients was confirmly diagnosed by TBLB,in which misdiagnosed non-specific pneumonia patients were 8 cases,misdiagnosed tuberculosis patients were 6 cases,misdiagnosed lung cancer patients were 5 cases,misdiagnosed pulmonary lymphoma patients were 4 cases,misdiagnosed pulmonary hypertension patients were 3 cases,misdiagnosed airway fibrosis centers patients were 2 cases.The number of female patients was significantly higher than that of male patients（27 vs 18,P0.01）.DILD patients with idiopathic interstitial pneumonia were the most（32 cases） in 45 cases,followed by connective tissue disease-related DILD（8 cases）,sarcoidosis（5 cases）.Conclusion TBLB is an effective diagnosis means of DILD.It would be valuable in differential diagnosis and classification diagnosis of DILD.