Laohaburanakit Petey, Chan Andrew, Allen Roblee P
Division of Pulmonary and Critical Care, Department of Internal Medicine, University of California, Davis, Davis, CA, USA.
Clin Rev Allergy Immunol. 2003 Dec;25(3):259-74. doi: 10.1385/CRIAI:25:3:259.
Bronchiolitis obliterans (BO) is a disease of small airways that results in progressive dyspnea and airflow limitation. It is a common sequela of bone marrow, lung, and heart-lung transplantation, but can also occur as a complication of certain pulmonary infections, adverse drug reaction, toxic inhalation, and autoimmune disorders. Non-transplant-related BO is rare and can mimic asthma and chronic obstructive pulmonary disease (COPD). In transplant-related BO, the diagnosis can be suggested by obstructive changes in serial pulmonary function testings, while open lung biopsy is usually required in non-transplant cases. High-resolution computerized tomography (HRCT) is also a helpful tool to diagnose and assess the severity of BO. The treatment of BO, regarding of the cause, is usually disappointing. Systemic corticosteroid immunosuppression and retransplantation have been described with variable success.
闭塞性细支气管炎(BO)是一种小气道疾病,可导致进行性呼吸困难和气流受限。它是骨髓、肺和心肺移植常见的后遗症,但也可作为某些肺部感染、药物不良反应、有毒气体吸入和自身免疫性疾病的并发症出现。非移植相关的BO较为罕见,可类似哮喘和慢性阻塞性肺疾病(COPD)。在移植相关的BO中,连续肺功能测试中的阻塞性改变可提示诊断,而在非移植病例中通常需要开胸肺活检。高分辨率计算机断层扫描(HRCT)也是诊断和评估BO严重程度的有用工具。无论病因如何,BO的治疗通常都不尽人意。全身性皮质类固醇免疫抑制和再次移植的疗效不一。