Tomii K, Iwata T, Oida K, Kohri Y, Taguchi Y, Nanbu Y, Kubo Y, Yuba Y, Mino M
Department of Respiratory Diseases, Tenri Hospital, Nara, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Apr;28(4):551-7.
Bronchiectasis has come to be considered as a type of sinobronchial syndrome in Japan, but there exist some cases without chronic sinusitis. We studied the clinical features of 14 cases of bronchiectasis with definitely normal paranasal sinus roentgenogram, diagnosed during the past ten years. There were eleven middle-aged women and three men. Ten patients (71%) complained of hemoptysis, one (7%) of dry cough, one (7%) of productive cough, and the two (14%) had no complaint. In seven patients (50%) CT and bronchography showed localized cylindrical bronchiectasis in the right middle lobe and/or left upper lobe lingular division. They were considered to be middle lobe lingular syndrome. Three patients (22%) with localized varicose or cystic bronchiectasis had a history of pneumonia or pertussis in their infancy, so their bronchiectasis were considered secondary to infantile bronchopulmonary disease. Two patients (14%) had diffuse cystic bronchiectasis and were almost asymptomatic. They might be cases congenital bronchiectasis or Williams-Campbell syndrome. Pulmonary function tests were normal in most of the cases and sputum culture revealed no cases of persistent bacterial infection. These clinical features are quite different from those of bronchiectasis reported as sinobronchial syndrome, in which chronic productive cough, poor pulmonary function, persistent bacterial infection, etc. are significant. So we conclude that there are two distinct groups in bronchiectasis.
在日本,支气管扩张症已被视为鼻支气管综合征的一种类型,但也存在一些没有慢性鼻窦炎的病例。我们研究了过去十年间确诊的14例鼻窦X线片完全正常的支气管扩张症患者的临床特征。其中有11名中年女性和3名男性。10名患者(71%)主诉咯血,1名(7%)主诉干咳,1名(7%)主诉咳痰,2名(14%)无主诉。7名患者(50%)的CT和支气管造影显示右中叶和/或左上叶舌段有局限性柱状支气管扩张。它们被认为是中叶舌段综合征。3名局限性静脉曲张型或囊状支气管扩张症患者在婴儿期有肺炎或百日咳病史,因此他们的支气管扩张被认为是继发于婴儿期支气管肺部疾病。2名患者(14%)有弥漫性囊状支气管扩张,几乎没有症状。他们可能是先天性支气管扩张症或威廉姆斯 - 坎贝尔综合征病例。大多数病例的肺功能测试正常,痰培养未发现持续性细菌感染病例。这些临床特征与作为鼻支气管综合征报道的支气管扩张症有很大不同,后者慢性咳痰、肺功能差、持续性细菌感染等表现较为显著。所以我们得出结论,支气管扩张症存在两种不同的类型。