特发性肺纤维化支气管肺泡灌洗后急性加重四例报告并文献复习_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

薛洪刚 ¹ ,  李尔然 ² , 李振华 ²

1. ;
2. ;

Corresponding author：

李尔然, Email: lierran@hotmail.com

Keywords：

特发性肺纤维化; 支气管肺泡灌洗; 急性加重; 诊断; 治疗

DOI：

10.7507/1671-6205.2015118

Video：

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Abstract Full text Figures/Tables Video References Cited by

目的探讨支气管肺泡灌洗和特发性肺纤维化急性加重之间的联系。方法收集2000年1月至2014年4月期间在中国医科大学附属第一医院呼吸内科住院并接受支气管肺泡灌洗的特发性肺纤维化患者, 对出现急性加重患者的临床特点进行分析总结。结果在153例接受支气管肺泡灌洗的特发性肺纤维化患者中, 有4例发生急性加重。其中男3例, 女1例; 年龄均大于50岁; 吸烟者2例; 肺功能用力肺活量＜预计值的60%和/或肺一氧化碳弥散量＜预计值的50%;支气管肺泡灌洗液细胞分类中中性粒细胞比例升高。大剂量糖皮质激素冲击治疗仍作为治疗特发性肺纤维化急性加重的首选。结论支气管肺泡灌洗可能诱发特发性肺纤维化急性加重, 激素冲击治疗有可能缓解特发性肺纤维化急性加重。

Citation： 薛洪刚, 李尔然, 李振华. 特发性肺纤维化支气管肺泡灌洗后急性加重四例报告并文献复习. Chinese Journal of Respiratory and Critical Care Medicine, 2015, 14(5): 487-489. doi: 10.7507/1671-6205.2015118 Copy

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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, 蔡后荣.特发性肺纤维化急性加重及感染的诊治.中国呼吸与危重监护杂志, 2015, 14:217-222.
9. 刘寅, 蔡礼鸣, 赵弘卿, 等.特发性肺纤维化急性加重21例临床回顾分析.中国呼吸与危重监护杂志, 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. 李国强, 张玉华, 魏路清, 等.肺叶切除术后特发性肺纤维化急性加重一例.中华结核和呼吸杂志, 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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特发性肺纤维化支气管肺泡灌洗后急性加重四例报告并文献复习

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