Six Cases Reported Of Diffuse Panbronchiolits And Literatures Reviewed

Objective Analyze the clinical character of diffuse panbronchiolitis.Method 6 cases who administrated in the first affiliated hospital of GuangXi medical university from April of 2005 to September of 2009 met the diagnostic criteria of DPB. the clinical symptoms, arterial gas analysis, lung function and radiology examination with the diagnostic criteria were acessed retrospectively.the effect of macrolides treatment were obsereed at the same time.Results①6 patients were included in this article,4 male and 2 female, age range:40-72 years.4 cases were misdiagnosed as COPD,1 as bronchoectasis. 1 as fibrous pneumonia.②Clinical symptoms:all patients presented with chronic cough, yellowish purulent sputum and dyspnea, the volume of sputum was about 50-500ml/d. Those patients had suffer these for 2-30 years.1 of them used to have hemoptysis on exertion; 2 cases used to suffer from chest paint. All cases had moist rales in their chest,2 have rhonchi at initial presentation,5 cases had chronic sinusitis.2 of them had a history of smoking.③Radiology:2 cases' chest X-ray showed diffuse fine nodular opacities, all of their CT scan revealed multiple centrilobular nodular shadows that were disseminated over both side of lung zones. All the patients had bronchoectasis,2 of their CT showed the history of pulmonary tuberculosis,5 of their sinus CT show a history of nasosinusitis.④Pulmonary function:all the lung function show a mixed obstructive-restrictive pattern, their FEV1/FVC were below normal range 4 cases <70%, all of their FEF25,FEF50,FEF75 had some kind of reduction which suggest the obstruction of small airway. The test also show decrease in VC, the patients'artery blood gas analyze show hyoxemia. The average value was 73.57mmHg.⑤Treatment:All the patients accepted the macrolides treatment: Erythromycin 400-600mg/d after the diagnose until the date of visit.5 of them had been under the therapy>2 years, at a average value of 27 month. All of their symptoms had been relieved, most of their FEV1/FVC and PaO2 also improved.Conclusions①The clinical manifestation of DPB was some kind of chronic respiratory symptoms. which were not special for diagnosis The X-ray and CT scan revealed multiple centrilobular nodular shadows that were disseminated over both side of lung zones.②long-term low-does macrolides therapy can be effective at relieving symptom.