摘要
目的提高对特发性肺纤维化急性加重(AEIPF)的临床认识,探讨其临床特点、诊断、治疗与预后。方法分析南京大学医学院附属鼓楼医院2010年9月至2013年11月收治的3例AEIPF患者的临床资料,并复习相关文献。结果 3例均为老年患者,男1例,女2例。均在无明确诱因的情况下1月内病情突然恶化,出现进行性的呼吸困难和严重的低氧血症。胸部高分辨率CT(HRCT)均表现为在原有特发性肺纤维化条索影和网格影、蜂窝肺的基础上出现新的磨玻璃影。接受激素冲击治疗后2例患者呼吸困难症状明显缓解,肺部磨玻璃影较前减少。1例患者胸部HRCT示磨玻璃影改变不明显,尽管使用有创性机械通气,仍死于呼吸衰竭。结论特发性肺纤维化患者可在无诱因下出现急性加重,AEIPF进展快,病死率高。糖皮质激素冲击治疗对部分患者有效。
Objective To improve the awareness of acute exacerbation of idiopathic pulmonary （AEIPF）, and to explore its clinical characteristics, diagnosis, treatment and outcome. Methods The clinical data of three patients with AEIPF in the Drum Tower Hospital affiliated to Nanjing University Medical School from September 2010 to November 2013 were recruited.The related literatures were reviewed. Results Three patients were aged from 65-74 years, and one of them was male and two were female. Their condition suddenly deteriorated in one month without clear incentive. Progressive dyspnea and severe hypoxemia were aggravated. Chest high resolution computed tomography （HRCT） showed new groundglass opacities on the basis of reticular shadow, honeycombing, and traction bronchiectasis of idiopathic pulmonary fibrosis. After corticosteroid treatment, the clinical symptoms of dyspnea of two patients significantly relieved, and pulmonary groundglass opacities reduced. However, one patient died of respiratory failure in the case of mechanical ventilation, and the groundglass opacities in his chest HRCT didn＇t reduce. Conclusions Idiopathic pulmonary fibrosis patients may have acute exacerbation in the absence of incentives.AEIPF progresses quickly and the mortality rate is high.Large dose of glucocorticoid treatment is effective for some part of these patients.
出处
《实用老年医学》
CAS
2014年第4期321-324,共4页
Practical Geriatrics
关键词
特发性肺纤维化
急性加重
磨玻璃影
糖皮质激素
idiopathic pulmonary fibrosis
acute exacerbation
groundglass opacities
corticosteroid
