Rikimaru T, Tanaka Y, Otaki M, Yokoyama T, Futapami E, Ginnouchi Y, Ichikawa Y, Oizumi K
First Department of Internal Medicine Kurume University School of Medicine, Fukuoka, Japan.
Kekkaku. 1991 Aug;66(8):511-6.
A total of 36 patients (16 male and 20 female) with tracheobronchial tuberculosis were admitted during the last nine years and were evaluated for their clinical features. The chief complaint in three quarters of the patients was intractable cough, in particular, in those with tracheal tuberculosis. One of three patients who suffered from wheezing was prescribed steroid, being diagnosed as having bronchial asthma instead of tuberculosis. Plain chest X-rays of two patients revealed no abnormality. Pleural effusion was observed in three patients, and miliary tuberculosis in two patients. Bronchial biopsy was carried out in 23 patients, however, in only 11 patients a histopathological diagnosis of tracheobronchial tuberculosis could be made. In contrast, in all 36 patients smear and/or culture for tubercle bacilli were positive. Therefore, bronchial biopsy was considered not to be essential in making a definite diagnosis of bronchial tuberculosis, although it did not exacerbate the lesion to lead to endobronchial stenosis. Only seven out of 36 patients were in the habit of smoking but three of the four had already broken the habit at least one year before being diagnosed as having the disease. The remaining four patients were still smoking but less than 10 cigarettes a day, with one exceptional patient who was smoking 30 cigarettes on average a day. It has been well known that there is a sexual difference in the incidence of bronchial tuberculosis, namely among females with relatively low population of smokers, the incidence is high. Another probable reason for the higher female incidence is assumed to be due to the structural susceptibility of the bronchus with smaller diameter lumen.(ABSTRACT TRUNCATED AT 250 WORDS)
在过去九年中,共收治了36例气管支气管结核患者(男16例,女20例),并对其临床特征进行了评估。四分之三患者的主要症状是顽固性咳嗽,尤其是气管结核患者。三名喘息患者中有一名被诊断为支气管哮喘而非结核,因此使用了类固醇药物。两名患者的胸部X线平片未见异常。三名患者出现胸腔积液,两名患者出现粟粒性结核。23例患者进行了支气管活检,但只有11例患者能够获得气管支气管结核的组织病理学诊断。相比之下,所有36例患者的结核杆菌涂片和/或培养均呈阳性。因此,虽然支气管活检不会加重病变导致支气管内狭窄,但对于明确诊断支气管结核并非必不可少。36例患者中只有7例有吸烟习惯,但其中4例中的3例在被诊断患有该病至少一年前就已戒烟。其余4例患者仍在吸烟,但每天吸烟少于10支,有1例例外患者平均每天吸烟30支。众所周知,支气管结核的发病率存在性别差异,即在吸烟人群相对较少的女性中发病率较高。女性发病率较高的另一个可能原因被认为是由于支气管管腔直径较小导致的结构易感性。(摘要截选至250字)