摘要
目的研究炭末沉着症与支气管色素沉着纤维化(BAF)的临床特征及关系。方法复习北京清华长庚医院2016年1月至2018年12月行电子气管镜检查591例患者,发现炭末沉着症病例71例,其中BAF组39例,非BAF组32例,回顾性分析其一般信息、病史、支气管镜结果、胸部CT、肺功能等检查资料并对比。结果炭末沉着症发生率为12.0%(71/591),BAF在炭末沉着症病例中占54.9%(39/71)。BAF组存在高龄[(77.0±10.4)岁]、女性比例高(59.0%)、吸烟患者少(25.6%)、合并结核感染比例高(41.0%)的特点。双上叶及右中叶支气管是炭末沉着最常见的部位,而右中叶支气管是最常出现狭窄及闭塞的位置。胸部CT检查提示69.0%的炭末沉着症患者存在纵隔或肺门淋巴结肿大或钙化,其中气管旁、两侧肺门及隆突下淋巴结最易受累。BAF组与非BAF组对比发现前者有更多的咳嗽、咳痰患者,而在年龄、性别、吸烟史、合并结核感染比例、炭末沉着分布、淋巴结异常情况等方面无显著差别。26例患者完成肺通气功能检查,BAF组中70.6%有阻塞性通气功能障碍,较非BAF组(22.2%)存在显著差异。结论炭末沉着症存在规律性的气道内分布,多伴有纵隔/肺门淋巴结肿大或钙化,与结核感染存在一定相关性。BAF可能是炭末沉着症更严重的类型。
Objective To investigate the clinical features and relationship of anthracosis and bronchial anthracofibrosis(BAF).Methods A retrospective study among 591 patients who did bronchoscopy in this hospital from January 2016 to December 2018 was performed.Of them,71 patients had anthracosis,including 39 BAF.Their clinical data,bronchoscopic results,CT scan and pulmonary function tests were analyzed and compared.Results The prevalence of anthracosis was 12.0%(71/591),while 54.9%(39/71)of anthrocosis were BAF.BAF patients shared features of old age(77.0±10.4),female domination(59.0%),low smoking ratio(25.6%)and high prevalence of tuberculosis(41.0%).Upper lobe bronchi and right lobe bronchus were the predominant sites of involvement.Right lobe bronchus was the most common site of stenosis or occlusion in BAF.According to CT scan,69.0%of all anthrocasis cases had enlarged or calcificated lymph node in mediastinal or hilar positions.Paratracheal,parahilar,subcarinal lymph nodes were most frequently involved.Compared BAF with non-BAF patients,BAF patients had significantly more cough and expectoration.There was no statistical differences in age,sex,smoking history,infection with tuberculosis,the distribution of anthracosis and abnormal lymph nodes.Though only 26 of 71 patients performed respiratory function tests,there were significantly more cases of obstructive ventilation function disturbance in BAF than in non-BAF patients.Conclusions Anthracosis occurs at regular locations in lung,usually accompanied with abnormal mediastinal/hilar lymph nodes and associated with tuberculosis.BAF might be a more severe type of anthracosis.
作者
安宇林
郭军
张明强
蔡存良
赵景全
牟向东
AN Yulin;GUO Jun;ZHANG Mingqiang;CAI Cunliang;ZHAO Jingquan;MU Xiangdong(Department of Respiratory and Critical Care Medicine,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,P.R.China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2019年第6期554-559,共6页
Chinese Journal of Respiratory and Critical Care Medicine
作者简介
共同第一作者:安宇林;共同第一作者:郭军;通信作者:牟向东,Email:mxda02600@btch.edu.cn。
