气道内超声协助诊断呼吸道受累复发性多软骨炎一例及文献复习_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

高平 , 劳妙婵 , 陈娉娉 , 张晓 ,  高兴林

广东省人民医院/广东省医学科学院呼吸科(广东广州 510080);

Corresponding author：

高兴林, Email: xinglingao@hotmail.com

Keywords：

气道内超声; 复发性多软骨炎

DOI：

10.7507/1671-6205.2015072

Video：

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目的提高对呼吸道受累的复发性多软骨炎(RP)的临床认识,以及气道内超声对气道壁疾病的诊断价值。方法对1例呼吸道受累的RP患者气道内超声协助临床诊疗过程进行分析,并结合文献复习。结果首发呼吸道症状有声嘶、咳嗽、咳痰、喘息、呼吸困难等,CT检查有气管、支气管狭窄、气管软骨变形等,支气管镜表现有不同程度的声带水肿、声门下环状软骨塌陷、声带麻痹、喉腔狭窄和主气道、左右支气管及其分支弥漫或局限狭窄、充血水肿、软骨结构消失。气道内超声显示气道壁分层模糊,软骨层破坏增厚、形状不规则。结论呼吸道受累的RP临床容易误诊,气道内超声对气道壁疾病具有潜在的诊断价值。

Citation： 高平, 劳妙婵, 陈娉娉, 张晓, 高兴林. 气道内超声协助诊断呼吸道受累复发性多软骨炎一例及文献复习. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(3): 295-297. doi: 10.7507/1671-6205.2015072 Copy

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1. 陈娉娉,陈正贤,何碧芳,等.正常气管壁超声图像及其对应的组织学分层的定量测量分析.中华结核和呼吸杂志,2012,35:409-412.
2. 高平,陈正贤,陈娉娉,等.EBUS对慢性阻塞性肺疾病气道重构的研究.临床肺科杂志,2012,7:1166-1168.
3. McAdam LP,O'Hanlan MA,Bluestone R,et al. Relapsing polychondritis:prospective study of 23 patients and a review of the literature. Medicine (Baltimore),1976,55:1932.
4. 中华医学会风湿病学会.复发性多软骨炎诊治指南(草案).中华风湿病学杂志,2004,4:251-253.
5. Behar JV,Choi YW,Hartman TA,et al. Relapsing polychondritis affecting the lower respiratory tract. Am J Roentgenol,2002,178:173.
6. Herth F,Ernst A,Schulz M,et al. Endobronchial ultrasound reliably differentiates between airway infiltration and compression by tumor. Chest,2003,123:458-462.
7. Septimiu M,Noriaki K,Henri C. Endobronchial ultrasound morphology of expiratory central airway collapse. Respirology,2008,13:315-319.
8. Miyazu YK,Miyazawa TY,Kurimoto NR,et al. Endobronchial ultrasonography in the diagnosis and treatment of relapsing polychondritis with tracheobronchial malacia. Chest,2003,124:2393-2395.
9. 钟南山,刘又宁,主编.呼吸病学.北京:人民卫生出版社,2012.
10. 史旭华,佟胜全,苏金梅,等.复发性多软骨炎呼吸道受累的特点.中华医学杂志,2006,86:1048.
11. 张家祺,李强,白冲,等.累及气道的复发性多软骨炎的临床特征及其处理.中华结核和呼吸杂志,2007,30:173-177.
12. Sharma A,Law A,Bambery P,et al. Relapsing polychondritis:clinical presentations,disease activity and outcomes. Orphanet J Rare Dis,2014,9:198.
13. Gorard C,Kadri S. Critical airway involvement in relapsing polychondritis. BMJ Case Rep,2014,Sep 11:2014.
14. 唐福林,胡清,石振峰,等.复发性多软骨炎19例临床分析.中华风湿病学杂志,1997,1:25-27.

Chinese Journal of Respiratory and Critical Care Medicine

气道内超声协助诊断呼吸道受累复发性多软骨炎一例及文献复习

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