胸腔病例（三四七）瀰漫性泛細支氣管炎

10.6666/ClinMed.201804_81(4).0043

李昶慶；陳穎瑩；蘇剛正

支氣管炎(bronchiolitis) ； 亞洲族群(Asia) ； 慢性鼻竇炎(chronic sinusitis) ； 巨環黴素抗生素(macrolide antibiotic)

臨床醫學月刊

81卷4期（2018 / 04 / 27）

247 - 253

繁體中文

瀰漫性泛細支氣管炎(diffuse panbronchiololitis)最早在1960年代被提及，是一個影響雙肺以及呼吸細支氣管(respiratory bronchioles)全層結構的疾病。主要發生在東亞洲國家、四十歲以上的族群，當中以男性、非吸菸者占多數。臨床上主要症狀為慢性咳嗽伴隨大量的痰液產生，超過八成人會出現慢性鼻竇炎(chronic sinusitis)。其致病原因未知，可能與環境與基因有關。常見胸部X光表現為雙側瀰漫性小結節病灶，並合併支氣管擴張症。而胸部電腦斷層則呈現中央小葉型結節(centrilobular nodules)。肺功能通常為阻塞型換氣功能障礙。治療主要為巨環黴素(Macrolide)，目前普遍使用紅黴素(Erythromycin)做為第一線用藥，能有效緩解症狀，並可能進一步促成肺功能和影像上的進步。

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