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[哮喘和哮喘样支气管炎中支气管壁增厚]

[Thickening of the bronchial wall in asthma and asthma-like bronchitis].

作者信息

Meneghello A, Molfese G, Rampazzo F, Gribaldo R

出版信息

Minerva Med. 1986 Jan 28;77(3-4):109-12.

PMID:3945414
Abstract

Small ring-shaped images, related to 2nd or 3rd bronchial walls are seen in prahilar lung region in 80% of chest Xray films, when a bronchus in seen "end on". This bronchial wall thickening (greater than 0.3 mm) is present in numerous lung diseases such as silicosis, bronchiectasis and pulmonary edema. In order to evaluate the significance of such bronchial wall thickening in chronic obstructive bronchitis and bronchial asthma, 78 patients suffering from these diseases have been studied correlating bronchial wall-thickening with the major clinical and bio-humoral indices of broncho obstruction a significant correlation was found between bronchial wall thickening and Tiffeneau index (p less than 0.05), the PaO2 (p less than 0.01), and the E.S.R., expressed as Katz index (p less than 0.001). No correlation was observed between bronchial wall thickening and positivity to allergological tests. It follows that the bronchial wall thickening is an expression of mucous membrane edema and/or endobronchial mucous or purulent hypersecretion. This aspect, though not usefull in the differential diagnosis between chronic obstructive bronchitis and paroxysmal bronchial asthma due to topical inhalants, is indicative of an acute phase in the inflammation process in such patients.

摘要

当支气管呈“端位”显示时,在80%的胸部X光片中,肺门区可见与第二或第三支气管壁相关的小环形影像。这种支气管壁增厚(大于0.3毫米)存在于许多肺部疾病中,如矽肺、支气管扩张和肺水肿。为了评估这种支气管壁增厚在慢性阻塞性支气管炎和支气管哮喘中的意义,对78例患有这些疾病的患者进行了研究,将支气管壁增厚与支气管阻塞的主要临床和生物体液指标相关联,发现支气管壁增厚与蒂芬诺指数(p<0.05)、动脉血氧分压(p<0.01)以及以卡茨指数表示的血沉(p<0.001)之间存在显著相关性。未观察到支气管壁增厚与变应性试验阳性之间的相关性。由此可见,支气管壁增厚是黏膜水肿和/或支气管内黏液或脓性分泌物过多的表现。这一情况虽然在因局部吸入剂导致的慢性阻塞性支气管炎和阵发性支气管哮喘的鉴别诊断中无用,但表明此类患者炎症过程处于急性期。

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