Ichikawa Y, Hotta M, Sumita S, Fujimoto K, Oizumi K
First Department of Internal Medicine and Radiology, Kurume University Medical School, Fukuoka, Japan.
Chest. 1995 Jan;107(1):120-5. doi: 10.1378/chest.107.1.120.
The clinical effectiveness of erythromycin for patients with diffuse panbronchiolitis (DPB) was previously recognized. However, it remains unknown what kind of airway lesions change with the clinical effectiveness induced by erythromycin. We performed the present study to clarify this unknown. We devised a method for scoring findings on high-resolution computed tomography (HRCT) to aid in the objective evaluation of the airway lesions in patients with DPB. The 18 patients with DPB were treated with oral erythromycin, 600 mg/d. All patients were evaluated by pulmonary function tests and HRCT before and after 3 months of therapy. Characteristic HRCT findings in patients with DPB pretherapy were small nodules, airway ectasia, periairway thickening, and mucus plugging. After erythromycin therapy, there was significant reduction in scores for the extent of small nodular opacities, the severity of periairway thickening, and the extent of mucus plugging with a corresponding significant improvement in results of the pulmonary function test parameters. The present study demonstrated reversible airway lesions in patients with DPB in response to erythromycin therapy.
红霉素对弥漫性泛细支气管炎（DPB）患者的临床疗效此前已得到认可。然而，尚不清楚红霉素诱导的临床疗效会使气道病变发生何种变化。我们开展本研究以阐明这一未知情况。我们设计了一种对高分辨率计算机断层扫描（HRCT）结果进行评分的方法，以辅助客观评估DPB患者的气道病变。18例DPB患者接受口服红霉素治疗，剂量为600mg/d。所有患者在治疗前和治疗3个月后均接受肺功能测试和HRCT评估。DPB患者治疗前的HRCT特征性表现为小结节、气道扩张、气道周围增厚和黏液嵌塞。红霉素治疗后，小结节状阴影范围、气道周围增厚严重程度以及黏液嵌塞范围的评分显著降低，肺功能测试参数结果相应显著改善。本研究证明DPB患者的气道病变对红霉素治疗有可逆性反应。
