特發性肺纖維化支氣管肺泡灌洗后急性加重四例報告并文獻復習_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

薛洪剛 ¹ ,  李爾然 ² , 李振華 ²

1. ;
2. ;

Corresponding?author：

李爾然, Email: lierran@hotmail.com

Keywords：

特發性肺纖維化; 支氣管肺泡灌洗; 急性加重; 診斷; 治療

DOI：

10.7507/1671-6205.2015118

Video：

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目的探討支氣管肺泡灌洗和特發性肺纖維化急性加重之間的聯系。方法收集2000年1月至2014年4月期間在中國醫科大學附屬第一醫院呼吸內科住院并接受支氣管肺泡灌洗的特發性肺纖維化患者, 對出現急性加重患者的臨床特點進行分析總結。結果在153例接受支氣管肺泡灌洗的特發性肺纖維化患者中, 有4例發生急性加重。其中男3例, 女1例; 年齡均大于50歲; 吸煙者2例; 肺功能用力肺活量＜預計值的60%和/或肺一氧化碳彌散量＜預計值的50%;支氣管肺泡灌洗液細胞分類中中性粒細胞比例升高。大劑量糖皮質激素沖擊治療仍作為治療特發性肺纖維化急性加重的首選。結論支氣管肺泡灌洗可能誘發特發性肺纖維化急性加重, 激素沖擊治療有可能緩解特發性肺纖維化急性加重。

Citation： 薛洪剛, 李爾然, 李振華. 特發性肺纖維化支氣管肺泡灌洗后急性加重四例報告并文獻復習. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(5): 487-489. doi: 10.7507/1671-6205.2015118 Copy

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15.	Antoniou KM, Wells AU.Acute exacerbations of idiopathic pulmonary fibrosis.Respiration, 2013, 86:265-274.

1. Reynolds HY, Newball HH.Analysis of proteins and respiratory cells obtained from human lungs by bronchial lavage.J Lab Clin Med, 1974, 84:559-573.
2. Meyer KC, Raghu G, Baughman RP, et al.An official American Thoracic Society clinical practice guideline:the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease.Am J Respir Crit Care Med, 2012, 185:1004-1014.
3. Hiwatari N, Shimura S, Takishima T, et al.Bronchoalveolar lavage as a possible cause of acute exacerbation in idiopathic pulmonary fibrosis patients.Tohoku J Exp Med, 1994, 174:379-386.
4. Kim DS, Park JH, Park BK, et al.Acute exacerbation of idiopathic pulmonary fibrosis:frequency and clinical features.Eur Respir J, 2006, 27:143-150.
5. Sakamoto K, Taniguchi H, Kondoh Y, et al.Acute exacerbation of IPF following diagnostic bronchoalveolar lavage procedures.Respir Med, 2012, 106:436-442.
6. American Thoracic Society.Idiopathic pulmonary fibrosis:diagnosis and treatment.International consensus statement.American Thoracic Society(ATS), and the European Respimtory Society(EBS).Am J Respir Crit Care Med, 2000, 161:646-664.
7. Raghu G, Collard HR, Egan JJ, et al.An official ATS/ERS/JRS/ALAT statement:idiopathic pulmonary fibrosis:evidence-based guidelines for diagnosis and management.Am J Respir Crit Care Med, 2011, 183:788-824.
8. 王鑫, 曹孟淑, 蔡后榮.特發性肺纖維化急性加重及感染的診治.中國呼吸與危重監護雜志, 2015, 14:217-222.
9. 劉寅, 蔡禮鳴, 趙弘卿, 等.特發性肺纖維化急性加重21例臨床回顧分析.中國呼吸與危重監護雜志, 2012, 11:362-366.
10. Ohshimo S, Bonella F, Cui A, et al.Significance of bronchoalveolar lavage for the diagnosis of idiopathic pulmonary fibrosis.Am J Respir Crit Care Med, 2009, 179:1043-1047.
11. Ryu YJ, Chung MP, Han J, et al.Bronchoalveolar lavage in fibrotic idiopathic interstitial pneumonias.Respir Med, 2007, 101:655-660.
12. Kinder BW, Brown KK, Schwarz MI, et al.Baseline BAL neutrophilia predicts early mortality in idiopathic pulmonary fibrosis.Chest, 2008, 133:226-232.
13. 李國強, 張玉華, 魏路清, 等.肺葉切除術后特發性肺纖維化急性加重一例.中華結核和呼吸雜志, 2010, 33:464-465.
14. Song JW, Hong SB, Lim CM, et al.Acute exacerbation of idiopathic pulmonary fibrosis:incidence, risk factors and outcome.Eur Respir J, 2011, 37:356-363.
15. Antoniou KM, Wells AU.Acute exacerbations of idiopathic pulmonary fibrosis.Respiration, 2013, 86:265-274.

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特發性肺纖維化支氣管肺泡灌洗后急性加重四例報告并文獻復習

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