弥漫性泛细支气管炎临床及影像学特征分析

Clinical and imaging characteristics of diffuse panbronchiolitis

目的通过对弥漫性泛细支气管炎(DPB)临床及影像学特征的分析,提高对本病的认识和诊疗水平。方法回顾性分析31例DPB患者临床资料,对其临床特点及影像学特征进行总结。结果所有患者均有咳嗽、咯痰,双肺可闻及湿啰音,29例(93.5%)出现劳力性呼吸困难;全部患者有副鼻窦炎或既往曾诊断为鼻窦炎;28例(90.3%)患者存在不同程度缺氧,1例(3.2%)血清冷凝集实验阳性28例(90.3%)患者存在阻塞性通气功能障碍,10例(32.3%)患者同时存在弥散功能障碍;28例(90.3%)患者出现沿支气管血管束分布的小叶中心性小结节,13例(41.9%)为典型"树芽征",3例(9.7%)伴细支气管扩张,3例(9.7%)出现肺间质纤维化改变。结论对于慢性咳嗽、咳痰、劳力性呼吸困难的患者,尤其是合并鼻窦炎时要考虑DPB的可能,应行相关检查以尽早诊断、治疗并改善预后。

Objective Through the analysis of the clinical and imaging characteristics of diffuse panbronchiolitis （DPB） ,we can improve the level of diagnosis and awareness of this disease. Method The clinical data of 31 DPB patients who had been admitted to Ningxia People＇s Hospital from March 2010 to December 2016 were collected and the clinical features and imaging characteristics were summarized. Results All patients had cough, expectoration and wet rales in pulmonary;exertional dyspnoea（ n = 29,93.5% ）. All patients suffered from Paranasal sinusitis or sinusitis diagnosed in the past. 28 patients（90.3% ）with different degrees of hypoxia;1 patients had the spositive entrum cold agglutination test ;28 patient （90.3%）with obstructive ventilatory dysfunction （90.3%） and 10 patients （32.3%） also exsist diffuse dysfunction. HRCT showed that 28 patients（90.3% ）with centrilobular nodular shadows distribution in the bronchial vascular bundle ; 13 patients （41.9% ） were typical tree - in - bud ;3 patients （9.7 % ） with bronchiectasis and 3 patients （9.7 % ） appear to pulmonary interstitial fibrosis change. Conclusion Patients who with chronic cough, sputum and exertional dyspnea, especially with sinusitis should be given to DPB and carry out the relevant inspection in order to diagnosis earlier and improve the prognosis.