Hayakawa H, Sato A, Imokawa S, Todate A, Chida K, Suzuki K, Iwata M
Department of Internal Medicine, National Sanatorium Tenryu Hospital, Hamakita.
Intern Med. 1998 Jun;37(6):504-8. doi: 10.2169/internalmedicine.37.504.
There is a considerable overlap between diffuse panbronchiolitis (DPB) and bronchiolar disease associated with rheumatoid arthritis. The present study assessed how these conditions could be differentiated. The subjects included 25 DPB patients and 15 RA patients with bronchiolar disease (RA-BD). Patients with either condition had chronic cough, purulent sputum, dyspnea and coarse crackles. Most patients with either DPB or RA-BD had a history of sinusitis as well as elevated cold hemagglutin titers and decreased levels in partial pressure of oxygen (PaO2), forced expiratory volume in one second (FEV1.0) and V 25/Ht. On histological examination, both conditions also shared various histological patterns although panbronchiolitis lesions were more common in DPB than RA-BD (68% vs 20%) and bronchiolar obliteration appeared to occur at more proximal sites in RA-BD than DPB. However, there were important differences: long-term treatment with erythromycin had less effect in RA-BD than DPB, and the frequency of HLA B54 tended to be higher in DPB than RA-BD (50.0% vs 22.2%), suggesting that they are distinct conditions.
弥漫性泛细支气管炎（DPB）与类风湿性关节炎相关的细支气管疾病之间存在相当大的重叠。本研究评估了如何区分这些病症。研究对象包括25例DPB患者和15例患有细支气管疾病的类风湿性关节炎（RA）患者（RA-BD）。这两种病症的患者均有慢性咳嗽、脓性痰、呼吸困难和粗湿啰音。大多数DPB或RA-BD患者有鼻窦炎病史，以及冷凝集素效价升高和氧分压（PaO2）、一秒用力呼气量（FEV1.0）和V 25/Ht水平降低。组织学检查显示，尽管细支气管炎病变在DPB中比RA-BD更常见（68%对20%），并且细支气管闭塞在RA-BD中似乎比DPB发生在更靠近近端的部位，但这两种病症也有各种共同的组织学模式。然而，两者存在重要差异：红霉素长期治疗对RA-BD的效果比对DPB的效果差，并且DPB中HLA B54的频率往往高于RA-BD（50.0%对22.2%），这表明它们是不同的病症。
