先天性肺气道畸形的临床特征:一项单中心研究

H. W. Yoo, Seong Heon Kim, Young Mi Kim, M. Kwak, H. Kim
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摘要

目的:先天性肺气道畸形(CPAM)是一种罕见的肺部发育异常。我们根据患者诊断时的年龄调查了CPAM的临床特征。方法:回顾性分析2000年1月至2019年12月在釜山国立大学医院诊断为CPAM的51例患者的病历。结果:调查儿童39例,成人12例。确诊时的平均年龄为15.9±14.3岁。儿童和成人在诊断CPAM时的平均年龄分别为6.8±5.8岁和31.2±10.2岁。调查的51例患者中,20例(39%)无症状,31例(61%)在诊断时出现干咳、反复呼吸道感染、呼吸困难等临床症状。值得注意的是,28名儿童(72%)在诊断时出现临床症状,而只有3名成人(25%)出现临床症状(P =0.006),儿童比成人更有症状。大囊肿患儿比小囊肿患儿更容易出现症状(P <0.001)。合并异常12例(23%)。右肺下叶囊性病变患者合并异常发生率较高(P =0.015)。手术切除40例(78%),预后良好。结论:本研究显示CPAM的临床症状在儿童和成人之间存在差异,取决于诊断年龄,右肺下叶囊肿患者往往表现出更高的联合异常患病率。(过敏哮喘呼吸疾病2021;9:21-26)
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Clinical characteristics of congenital pulmonary airway malformation of the lungs: A single-center study
Objective: Congenital pulmonary airway malformation (CPAM) is a rare developmental abnormality of the lungs. We investigated clinical characteristics of CPAM based on patient age at diagnosis. Methods: In this retrospective study, we analyzed the medical records of 51 patients diagnosed with CPAM at Pusan National University Hospital between January 2000 and December 2019. Results: We investigated 39 children and 12 adults. The mean age at the diagnosis of the patients was 15.9 ± 14.3 years. The mean ages of children and adults at the time of diagnosis of CPAM were 6.8 ± 5.8 years and 31.2 ± 10.2 years, respectively. Among the 51 patients investigated, 20 (39%) were asymptomatic and 31 (61%) showed clinical symptoms, such as dry cough, recurrent respiratory infections, and dyspnea at the time of diagnosis. Notably, clinical symptoms at diagnosis were observed in 28 children (72%) and in only 3 adults (25%) (P = 0.006), and children were more symptomatic than adults. Children with large cysts tended to be more symptomatic than those with small cysts (P < 0.001). Combined anomalies were detected in 12 patients (23%). Patients with cystic lesions in the right lower lobe of the lung showed a higher prevalence of combined anomalies (P =0.015). Surgical resection was performed in 40 patients (78%), and all patients showed good prognosis. Conclusion: This study revealed that the presence of clinical symptoms of CPAM differed between children and adults, depending on the age at diagnosis and that patients with cysts in the right lower lobe of the lungs tended to show a higher prevalence of combined anomalies. (Allergy Asthma Respir Dis 2021, 9: 21–26)
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