CAJ | 학술논문

目的探讨弥漫性泛细支气管炎(DPB)的临床特点及治疗.方法回顾性分析我院2例确诊为DPB患者的临床特点及治疗,并复习相关文献.结果 2例均以慢性咳嗽、咳痰伴活动后气促为主诉,肺部听诊均闻及湿啰音,HLA-B54均阳性,但冷凝集试验均阴性,肺功能均以阻塞性通气功能障碍为主；1例经病理确诊,胸部影像见典型弥漫小叶中心性结节影,但无慢性鼻窦炎病史,口服阿奇霉素0.25g,隔日1次,治疗12个月后肺部病灶明显吸收；1例经临床确诊,胸部影像见典型弥漫结节影伴支气管扩张和间质性肺纤维化,既往有慢性鼻窦炎病史,口服阿奇霉素0.25 g,隔日1次,治疗7个月后肺部病灶明显吸收；2例患者初期均长期误诊.结论 2例患者具有DPB典型临床表现,但某些特征有别于一般日本DPB患者,2例病例均显示长期口服小剂量阿奇霉素治疗DPB效果显著.
목적 탐토미만성범세지기관염(DPB)적림상특점급치료.방법 회고성분석아원2례학진위DPB환자적림상특점급치료,병복습상관문헌.결과 2례균이만성해수、해담반활동후기촉위주소,폐부은진균문급습라음,HLA-B54균양성,단냉응집시험균음성,폐공능균이조새성통기공능장애위주；1례경병리학진,흉부영상견전형미만소협중심성결절영,단무만성비두염병사,구복아기매소0.25g,격일1차,치료12개월후폐부병조명현흡수；1례경림상학진,흉부영상견전형미만결절영반지기관확장화간질성폐섬유화,기왕유만성비두염병사,구복아기매소0.25 g,격일1차,치료7개월후폐부병조명현흡수；2례환자초기균장기오진.결론 2례환자구유DPB전형림상표현,단모사특정유별우일반일본DPB환자,2례병례균현시장기구복소제량아기매소치료DPB효과현저.
Objective To recognize the clinical characteristics and therapy for diffuse panbronchiolitis (DPB) more clearly.Methods Two patients with DPB who once administrated in our department were retrospectively analyzed and literatures were reviewed.Results Both of them suffered from persistent cough,sputum,and exertional dyspnea,and auscultation revealed coarse crackles,and the detection of HLA-B54 was positive,but the titre of cold haemagglutinin was negative,and pulmonary function tests of them showed a significant airflow limitation.One patient who was diagnosed by thoracoscopic lung biopsy,characterised with bilateral diffuse small nodular shadows on a plain chest radiography film and centrilobular micronodules on chest computed tomography images and without a history of chronic paranasal sinusitis,and then recovered after 0.25 g azithromycin administered every other day for 12 months.The other who was definitely established by diagnostic criteria for DPB,characterised with bilateral,diffuse,small nodular shadows,bronchiectasis and interstitial pulmonary fibrosis on chest computed tomography images and also without a history of chronic paranasal sinusitis,and then recovered after 0.25 g azithromycin administered every other day for 7 months.The image typing of two patients was no significant correlation with the clinical severity,and both of them were initially long-term misdiagnosed.Conclusions This group of patients had showed the typical clinical manifestations of DPB,but some characteristics are different from Japan patients,and it has showed longterm oral administration of small doses of azithromycin in the treatment of DPB is significantly effect.