儿童支气管扩张91例病因分析

摘要

Objective To get more knowledge about the etiology of bronchiectasis in children. Methods Ninety-one children ( 54 males and 37 females ) aged 17 months to 14 years were included, who were finally diagnosed as bronchiectasis in the Beijing Children's Hospital from March 2002 to August 2008. Lung computed tomography or high resolution computed tonography which can show the extention and range of bronchodilation clearly were all performed to these patients. The diagnostic standard of bronchiectasis was thai the diameter of the bronchus was greater than the blood vessels nearby. If single lobe was involved in, it was defined as local bronchiectasis, and if 2 or more than 2 lobes involved in, it was defined as diffused bronchiectasis. Results Of the 91 patients with bronchiectasis, 9 were primary immune deficiency diseases, 33 after pneumonia ( 15 were mycoplasmal pneumonia, 3 tuberculosis, 2 measles complicated pneumonia, 13 other sever pneumonia ), 8 were primary ciliary dyskinesia, and etiology of other 22 cases were unknown. One case had dysfunctional swallow, 7 cases were caused by foreign body, 1 had diffused panbronchiolitis, 1 had interstitial pneumonia, 9 had bronchiolitis obliterans ( 7 after infection, 2 after StevensJohnson syndrome ). Nine primary immune deficiency, 8 primary ciliary dyskinesia and 9 bronchiolitise obliteran were all appeared as diffused bronchiectasis, 28 cases after pulmonary infection and 7 cases caused by foreign body were all appeared as local bronchiectasis. Seventy-seven patients had reccurent pneumonia history, and 88 cases related with infection Conclusions There are differences in the etiology between diffused bronchiectasis and local bronchiectasis.Reccurent and chronic pulmonary infection is related to bronchiectasis.%目的 提高对支气管扩张病因的认识.方法 选择2002年3月至2008年8月于北京儿童医院住院确诊为支气管扩张的患儿91例.其中男54例,女37例;年龄1岁5个月～14岁.均经肺CT或高分辨CT(HRCT)检查,诊断为支气管扩张.结果 91例支气管扩张患儿中,原发性免疫功能缺陷病9例;肺炎感染后33例,其中15例为支原体肺炎后,3例为结核感染后,2例为麻疹后,13例为其他严重肺炎后;原发的纤毛运动障碍8例;吞咽功能不协调1例;异物引起者7例;弥漫性泛细支气管炎(DPB)1例;间质病变1例;闭塞性细支气管炎(BO)9例(其中Stevens-Johnson综合征2例);原因不明22例.9例原发的免疫功能缺陷、8例原发的纤毛运动障碍和9例BO均为弥漫性支气管扩张.28例肺炎感染后和7例异物所致者均为局限性的支气管扩张.77例患儿有反复肺炎病史,88例与感染有关.结论 弥漫性支气管扩张和局限性的支气管扩张的病因不同,支气管扩张与反复和慢性肺部感染有关.