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目的提高对维吾尔族饲鸽者肺疾病的认识及诊断水平。方法选取2012年8月至2015年6月喀什、和田地区医院及新疆维吾尔自治区人民医院维吾尔族饲鸽者肺患者62例的临床资料,从临床表现、血清学检查、肺功能、胸部影像学改变、支气管肺泡灌洗液(BALF)细胞学等方面进行综合分析。结果 62例患者中男54例(87.1%),女8例(12.9%),年龄28~77岁,中位年龄(52.72±12.45)岁;病程>7年的患者49例(79.0%);常见临床表现为气短、呼吸困难(74.2%)、咳嗽、咳痰(91.9%)、发热(4.84%);肺功能以弥散功能障碍(85.5%)以及限制性通气功能障碍(82.3%)为主;影像学除表现为磨玻璃影17例(27.4%)、小叶中心性结节影10例(16.2%)、气体陷闭征或马赛克征10例(16.2%)外,还可见网格影或伴蜂窝肺29例(46.8%)、牵张性支气管扩张3例(4.84%)以及小叶间隔增厚3例(4.84%)表现;BALF细胞学:53例患者行支气管肺泡灌洗其中50例(50/53)患者淋巴细胞比例增高>40%;血清学检查:外周血嗜酸粒细胞比例、Ig E抗体水平均不高;血清沉淀抗体Ig G阳性48例(77.4%)。结论饲鸽者肺诊断有一定难度,且容易误诊,肺活检病理诊断相当困难,不宜实施,但仍可通过暴露病史或血清沉淀抗体阳性、影像、BALF细胞学分析等做出临床诊断,及早诊治。
Objective To improve the level of awareness and diagnosis of lung disease among Uighur nationals. Methods From August 2012 to June 2015, 62 cases of lung patients with Uigur nationality pigeon from Kashgar, Wada Regional Hospital and People’s Hospital of Xinjiang Uygur Autonomous Region were selected. Clinical data, serology, lung function and chest radiography , Bronchoalveolar lavage fluid (BALF) cytology and other aspects of a comprehensive analysis. Results Of the 62 patients, 54 (87.1%) were male and 8 (12.9%) were female, ranging in age from 28 to 77 years with a median age of 52.72 ± 12.45 years; 49 (79.0%) had a disease course of> 7 years; Common clinical manifestations are shortness of breath, difficulty breathing (74.2%), cough, expectoration (91.9%), fever (4.84%), diffuse dysfunction (85.5%) and restrictive ventilatory dysfunction (82.3%) ; In addition to imaging showed 17 cases of ground glass (27.4%), lobular central nodules in 10 cases (16.2%), gas trap or mosaic sign in 10 cases (16.2%), but also the grid shadow or 29 cases (46.8%) accompanied with honeycomb lungs, 3 cases (4.84%) with stretch bronchiectasis and 3 cases (4.84%) with interlobular septal thickening; BALF cytology: bronchoalveolar lavage in 53 cases 50/53). The serological examination showed that the proportion of peripheral blood eosinophils and IgE antibody were not high. Serum IgM was precipitated in 48 cases (77.4%). Conclusion Fecal pigeons have some difficulty in diagnosis and are easily misdiagnosed. Pathological diagnosis of lung biopsy is rather difficult and should not be implemented. However, clinical diagnosis and early diagnosis and treatment may be made by exposure history or serum precipitated antibody positive, imaging and BALF cytology analysis. .