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间质性肺疾病的诊疗困境

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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.
The challenges of diagnosis and management of interstitial lung disease
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.

Interstitial lung diseasesDiagnosisTreatment

张煜轩、瞿介明

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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

间质性肺疾病 诊断 治疗

上海市呼吸传染病应急防控与诊治重点实验室项目上海市重点专科项目上海市重大传染病研究基地培育项目上海地方高水平大学创新研究团队项目

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2024

实用医院临床杂志
四川省医学科学院 四川省人民医院

实用医院临床杂志

CSTPCD
影响因子:1.179
ISSN:1672-6170
年,卷(期):2024.21(2)
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