| 摘要: |
| 目的 分析弥漫性泛细支气管炎（diffuse panbronchiolitis, DPB）的临床特征，以提高临床医师对该病的认识水平。方法 回顾性分析2018年1月至2025年12月川北医学院附属医院收治的15例DPB患者的临床资料。对患者的一般临床特征、实验室检查、肺功能检查、胸部影像学检查、支气管镜检查、纤毛活检结果、治疗方案及转归情况进行总结。结果 15例DPB患者中男性8例，女性7例，年龄14～73（40.3±15.2）岁；发病年龄11～50（28.9±12.5）岁。15例DPB患者均有反复咳嗽、咳痰症状。15例DPB患者既往均有诊断其他呼吸系统疾病。9例患者进行了全血人类白细胞抗原(human leucocyte antigen, HLA)基因分型检测，其中HLA-A11阳性5例，HLA-A24阳性7例，HLA-B40阳性5例，HLA-B54阳性2例。15例患者中存在阻塞型通气功能障碍11例，混合型通气功能障碍4例，小气道功能异常14例，大气道阻塞12例。肺部影像学检查均见双肺散在分布的小叶中心性结节状密度增高影。8例DPB患者进行了电子支气管镜检查、纤毛超微结构电镜检查，其中纤毛结构正常7例，结构异常1例。15例患者均使用大环内酯类药物治疗，其中治愈2例，明显好转11例，复发2例。 结论 DPB临床表现缺乏特异性，易误诊、漏诊，早诊、早治是改善患者预后的关键。 |
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hefang,yangdongmei,wuhang
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Affiliated Hospital of North Sichuan Medical College
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| Abstract: |
| Objective To analyze the clinical characteristics of diffuse panbronchiolitis (DPB), so as to improve clinicians' understanding of the disease. Methods The clinical data of 15 patients with DPB admitted to the Affiliated Hospital of North Sichuan Medical College from January 2018 to December 2025 were analyzed retrospectively. The general clinical features, laboratory examination, pulmonary function examination, chest imaging examination, bronchoscopy, ciliary biopsy results, treatment and outcome of the patients were summarized. Results Among the 15 patients with DPB, there were 8 males and 7 females, with the age ranging from 14 to 73 (40.3±15.2) years and the onset age ranging from 11 to 50 (28.9±12.5) years. All 15 patients with DPB presented with recurrent cough and expectoration. All 15 DPB patients had a prior diagnosis of other respiratory diseases. Nine patients underwent whole-blood human leukocyte antigen (HLA) genotyping. Among them, 5 were positive for HLA-A11, 7 for HLA-A24, 5 for HLA-B40, and 2 for HLA-B54. Among the 15 patients, 11 had obstructive ventilatory dysfunction, 4 had mixed ventilatory dysfunction, 14 had small?airway dysfunction, and 12 had large?airway obstruction. All patients showed scattered centrilobular nodular opacities in both lungs on pulmonary imaging. Eight patients with DPB underwent electronic bronchoscopy and transmission electron microscopy for ciliary ultrastructural examination. Of these, 7 had normal ciliary structure and 1 had abnormal ciliary structure. All 15 patients were treated with macrolides. Among them, 2 achieved cure, 11 had marked improvement, and 2 experienced recurrence. Conclusion The clinical manifestations of DPB lack specificity, rendering it prone to misdiagnosis and missed diagnosis. Early diagnosis and early treatment are crucial for improving patients’ prognosis. |
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