美国胸科协会(ATS)和欧洲呼吸学会(ERS)联合发表的共识中,将特发性肺纤维化(IPF)定义为原因不明并以普通型间质性肺炎(UIP)为特征性病理改变的一种慢性纤维化性间质性肺疾病。在2000年ATS/ERS的IPF共识意见 及2003年中华医学会呼吸病学分会IPF的诊断和治疗指南(草案) 中均推荐的治疗方案为糖皮质激素,或与细胞毒制剂(环磷酰胺及硫唑嘌呤)联合使用。但目前尚缺乏循证医学证据支持该治疗方案能够提高IPF患者生活质量或生存率 。近年来随着对IPF的发病机制认识的深入,越来越多的临床医师和研究者对IPF患者是否需要用糖皮质激素等药物的治疗提出了质疑。
Citation:
CAI Hourong. Idiopathic pulmonary fibrosis:acting or waiting?. Chinese Journal of Respiratory and Critical Care Medicine, 2008, 08(5): 321-322. doi:
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- 1. Demedts M,Costabel U.ATS/ERS international multidiscipIinary consensus classification of the idiopathic interstitial pneumonias.Eur Respir J,2002,19:794-796..
- 2. American Thoracic Society.Idiopathic pulmonary fibrosis:diagnosis and treatment.International consensus statement.American Thoracic Society(ATS),and the European Respiratory Society (ERS).Am J Respir Crit Care Med.2000,161:646-664..
- 3. 中华医学会呼吸病学分会.特发f生肺(间质)纤维化诊断和治疗指南(草案).中华结核和呼吸杂志,2002,25:387-389..
- 4. Raghu G.Idiopathic pulmonary fibrosis:treatment options in pursuit of evidence-based approaches.Eur Respir J,2006,28:463-465..
- 5. Lynch JP 3rd,White E,Flaherty K.Corticosteroids in idiopathic pulmonary fibrosis.Curr Opin Pulm Med,2001,7:298-308..
- 6. Swigris JJ,Kuschner WG,Kelsey JL,et al.Idiopathic pulmonary fibrosis:challenges and opportunities for the clini cian and investigator.Chest,2005,127:275—283..
- 7. Sjoraker JA,Ryu JH,Edwin MK,et al.Prognostic significanoe of histopathologic subsets in idiopathic pulmonary fibrosis.Am J Respir Crit Care Med,1998,157:199-203..
- 8. Daniels CE,Ryu JH.Treatment of idiopathic pulmonary fibmsis.Semin Respir Crit Care Med,2006,27:668-676..
- 9. Collard HR,Ryu JH,Douglas WW ,et al.Combined cortico-steroid and cyclophosphamide therapy does not alter Survival in idiopathic pulmonary fibrosis.Chest,2004,125:2169-2174.
- 10. Raghu G,Depaso WJ,Cain K.Azathiopfine combined with prednisone in the treatment of idiopathic pulmonary fibrosis:a prospective double-blind,randomized,placebo-controlled clinical tria1.Am Rev Respir Dis,1991,144:291-296..