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目的：明确Ｘ线胸片正常咯血患者的病因。方法：对５７例Ｘ线胸片正常咯血者先后行胸部ＣＴ扫描和纤维支气管镜检查，就两者联合检查诊断率与各单项检查诊断率进行对比，并对病因构成进行分析。结果：ＣＴ和纤维支气管镜联合检查总诊断率为６３．１％（３６／５７），单纯ＣＴ诊断率为４３．９％（２５／５７），单纯纤维支气管镜检查诊断率为３５％（２１／５７），两者对比有非常显著差异（Ｐ＜０．０１）。在病因的构成中，炎症、支气管扩张和结核占多数（５１％），肺癌占少数（８．８％）。在２１例无诊断结论的患者中，８例（３８％）明确了段或亚段水平的出血部位。结论：ＣＴ和纤维支气管镜联合检查在胸片正常咯血患者的诊断中有互补作用，两者综合考虑能明确提高诊断率。
Objective: To clarify the etiology of patients with normal hemoptysis on X-ray. Methods: Fifty-seven cases of normal hemoptysis with chest X-ray were followed up by chest CT scan and fiberoptic bronchoscopy. The diagnostic rates of the two combined tests were compared with the diagnostic rates of the individual examinations, and the etiology was analyzed. Results: The total diagnostic rate of CT and fiberoptic bronchoscopy was 63.1% (36/57). The diagnostic rate of pure CT was 43.9% (25/57), and the diagnostic rate of simple fiberoptic bronchoscopy was 35% (21 / 57), there is a very significant difference between the two (P <0.01). Inflammation, bronchiectasis and tuberculosis (51%) and lung cancer (8.8%) were the major causes of etiology. Of the 21 patients with no diagnostic findings, 8 (38%) identified the site of bleeding at the segment or sub-level. Conclusion: Combined CT and fiberoptic bronchoscopy in the diagnosis of chest X-ray in patients with normal hemoptysis complement each other, both can definitely improve the diagnosis rate.