骨化性气管支气管病33例临床分析

Clinical analysis of 33 cases of tracheobronchopathia osteochondroplastica

目的:探讨骨化性气管支气管病(TO)的临床特征、影像学表现、诊断、治疗及预后。方法:收集2014年11月至2021年11月郑州大学第一附属医院收治的TO患者33例的临床资料并进行回顾性分析。结果:33例患者中男21例,女12例,发病年龄24~78(56.0±11.0)岁,病程15~90个月,咳嗽常见(19/33),合并肺部感染18例,肺癌6例;TO患者胸部CT多表现为钙化结节突入管腔,以气管支气管受累为主,CT检出率低;支气管镜检查结果显示TO以气管受累最多见,右主支气管次之,镜下常为弥漫型;病理学特征常为黏膜慢性炎症改变;行肺功能检查的10例中有5例阻塞性通气功能障碍,其中出现吸气相平台3例,吸气呼气双相平台1例;多数以对症治疗为主,预后良好。结论:TO症状不典型,胸部CT、肺功能检查有提示作用,支气管镜结合病理活检是诊断及鉴别诊断的主要手段,对症治疗后预后良好。

Aim:To investigate the clinical features, imaging findings, diagnosis, treatment and prognosis of tracheobronchopathia osteochondroplastica(TO).Methods:Clinical data of 33 patients with TO admitted to the First Affiliated Hospital of Zhengzhou University from November 2014 to November 2021 were analyzed retrospectively.Results:Among the 33 patients, 21 were male and 12 were female.The age of onset was 24-78(56.0±11.0) years old and the course of disease was 15-90 months.Cough was common(19/33).Eighteen cases were complicated with pulmonary infection, and 6 cases with lung cancer.Chest CT of patients with TO mostly showed calcified nodules protruding into the lumen, mainly involving the trachea and bronchus, and the detection rate of CT was low.The results of bronchoscopy showed that the most common site of TO was the trachea, followed by the right main bronchus.Diffuse lesions were often seen under bronchoscope.The pathological features were often chronic inflammation of mucosa.Pulmonary function examination was performed in 10 cases, including 5 cases with obstructive ventilatory dysfunction, 3 cases with inspiratory platform and 1 case with inspiratory and expiratory biphasic platform.Most of the patients were treated symptomatically and had good prognosis.Conclusion:The symptoms of TO are not typical, chest CT and pulmonary function have a reminder role.Bronchoscopy combined with pathological biopsy is the main means of diagnosis and differential diagnosis, and the prognosis is good after symptomatic treatment.