Clinical Comprehensive Analysis Of 24 Patients With Diffuse Panbronchiolitis

Objective:By discussing and summarizing the clinical characteristics of Diffuse panbronchiolitics(DPB)in order to improve clinical doctors' perception of Diffuse panbronchiolitics,reduce the misdiagnosis rate and improve patients' prognosis.Methods:We retrosprectively analyzed the clinical data of 24 patients who had been admitted to the respiratory departm of China-Japan Union Hospital of Jilin University from October 2009 to October 2016 due to DPB.Results:Among the 24 patients,15 cases were male(62.5%),and 9 cases were female(37.5%).Mean age was 58.0±13.58 years.Medical history was 11.7 years(range,2 months to 35 years).The clinical features include chronic cough(24/24,100%),expectoration(24/24,100%),exertional dyspnea(22/24,91.7%),hemoptysis or bloodin phlegm(5/24,20.8%),fever(9/24,37.5%),cyanosis(7/24,29.2%),crackles(24/24,100%),digital clubbings(10/24,41.7%),chronic sinusutis or past medical history(19/24,79.2%),smoking history(6/24,25.0%),19 cases of sputum culture were collected,Pseudomonas aeruginosa were isolated from 11 patients(11/19,57.89%),Klebsiella pneumoniae and Haemophilus influenzae respectively from 2 patients(2/19,10.53%),and normal bacteria in the other 4 cases(4/19,21.05%).CT scan shows bilateral,diffuse,small centrilobular nodular.Significantly in the middle and lower lobe lung field.Mean FEV1/FVC was 55.20±7.71%,FEV1%pred was 56.49± 7.996%.22 patients had hypoxemia.Mean Pa O2 was 60.64± 8.27 mm Hg,Pa CO2 was 47.85±6.25 mm Hg of 22 patients;4 patients were examined by fiberoptic bronchoscopy.The lymphocytes and plasma cells were observed in the bronchioles and their surrounding tissues.In this group of cases 13 cases were diagnosed respectively chronic bronchitis(6/13,46.1%),bronchiectasis(4/13,30.8%),bronchial asthma(2/13,15.4%),miliary tuberculosis(1/13,7.7%);24 cases recieved therapy of 14-membered or 15 membered ring macrolides.After treatment,the symptoms were improved and the lung soung reduction.Conclusion:1.The incidence of DPB is low.In recent years,with the development of medicine and the efforts of doctors,the cases of DPB was reported successively;2.The clinical features of DPB are not specific,and misdiagnosis and missed diagnosis is high.We need to study the clinical characteristics of diffuse panbronchiolitis,combine with the related auxiliary examinatin,and improve the accuracy of diagnosis;3.The therapy of low-dose and long-term 14-membered or 15 membered ring macrolides can improve the prognosis of patients.