CAJ | 학술논문

支气管扩张症是气道多种病原菌清除不良与反复感染引起的慢性炎症与支气管壁破坏,导致气道永久性扩张.非囊性纤维化支气管扩张症(non-cystic fibrosis bronchiectasis,NCFB)是一种临床低估的疾病,诊断时要注意其基础病因,但大多数病因不清楚.治疗要强调个体化并注意随访,临床评价常用的工具是莱斯特咳嗽问卷与痰液颜色.要对细菌定植进行定期评价.NCFB的治疗研究很少,长期应用抗生素可改善临床症状,但不降低急性加重发生率,也不改善肺功能.有严重感染或出血危险性的1或2叶严重损害的患者可考虑手术治疗.本文重点为NCFB,指出了其处理及肺移植治疗,进一步研究其病理生理学机制与探索新的治疗方法是非常必要的.
지기관확장증시기도다충병원균청제불량여반복감염인기적만성염증여지기관벽파배,도치기도영구성확장.비낭성섬유화지기관확장증(non-cystic fibrosis bronchiectasis,NCFB)시일충림상저고적질병,진단시요주의기기출병인,단대다수병인불청초.치료요강조개체화병주의수방,림상평개상용적공구시래사특해수문권여담액안색.요대세균정식진행정기평개.NCFB적치료연구흔소,장기응용항생소가개선림상증상,단불강저급성가중발생솔,야불개선폐공능.유엄중감염혹출혈위험성적1혹2협엄중손해적환자가고필수술치료.본문중점위NCFB,지출료기처리급폐이식치료,진일보연구기병리생이학궤제여탐색신적치료방법시비상필요적.
Bronchiectasis is permanently dilated airways caused by chronic bronchial inflammation secondary to inappropriate clearance of various micro-organisms and recurrent infections in the airways,as well as destruction of the bronchial walls.Non-cystic fibrosis bronchiectasis (NCFB) is an underestimated disease.At diagnosis,one should search for the underlying disease process.However,in a substantial number of patients no cause is found.The patients need individualised therapy and follow-up by monitoring of their symptoms.Useful tools are the Leicester cough questionnaire and the sputum colour chart.Screening patients for bacterial colonisation on a regular basis seems to be important,as many patients become colonised by pathogenic microorganisms.Treatment for NCFB lacks evidence.Prolongeduse antibiotics improve clinical response rates,but may not reduce exacerbation rates or relieve lung function.Surgery is often considered for people with extreme damage to one or two lobes of the lung who are at risk for severe infection or bleeding.In this review,the authors will focus on NCFB,pointing out in management and lung transplantation.Further research into the underlying pathophysiological mechanisms and trials evaluating new treatments are necessary.