间质性肺疾病的诊疗困境
The challenges of diagnosis and management of interstitial lung disease
张煜轩 1瞿介明1
作者信息
- 1. 上海交通大学医学院附属瑞金医院呼吸与危重症医学科,上海 200025;上海市呼吸传染病应急防控与诊治重点实验室,上海 200025;上海交通大学医学院呼吸病学研究所,上海 200025
- 折叠
摘要
间质性肺疾病是一类以肺间质炎症与纤维化为主要表现的临床异质性疾病总称.因间质性肺疾病临床-影像-病理特点之间存在交叉和重叠,其诊断和治疗仍面临较多困境.在诊断方面,间质性肺疾病早期诊断率低,根据影像学改变、支气管肺泡灌洗液标本,甚至肺部组织标本也难以明确疾病类型诊断;在治疗方面,除某些已知病因的继发性间质性肺疾病,大多间质性肺疾病只能通过免疫抑制和抗纤维化治疗延缓疾病进程,目前缺乏抗纤维化的特效药物.随着相关发病机制研究和新诊治技术手段的应用,期待间质性肺疾病的诊疗困境将逐步得到解决.
Abstract
Interstitial lung disease(ILD)are a general term for a group of clinically heterogeneous diseases characterized by inflammation and fibrosis of the lung interstitium.Due to the overlap and intersection of the clinical,radiological and pathological features of ILD,its diagnosis and treatment still face many challenges.In terms of diagnosis,the early diagnosis rate of ILD is low.It is difficult to confirm the disease type based on changes in imaging,specimens of bronchoalveolar lavage fluid or even lung tissue speci-mens.In terms of treatment,except for some secondary ILD with known etiology,most ILD can only delay the progression of disease with immunosuppressive and anti-fibrotic treatment.There is currently a lack of specific anti-fibrotic drugs.With the application of related pathogenesis research and new diagnostic and therapeutic techniques,it is expected that the difficulties in the diagnosis and treatment of ILD will be gradually overcome.
关键词
间质性肺疾病/诊断/治疗Key words
Interstitial lung diseases/Diagnosis/Treatment引用本文复制引用
基金项目
上海市呼吸传染病应急防控与诊治重点实验室项目(20dz2261100)
上海市重点专科项目(shslczdzk02202)
上海市重大传染病研究基地培育项目(20dz2210500)
上海地方高水平大学创新研究团队项目()
出版年
2024
NETL
NSTL
万方数据