Thaon I, Reboux G, Moulonguet S, Dalphin J C
Service des Maladies Professionnelles, CHU de Besançon, France.
Rev Mal Respir. 2006 Dec;23(6):705-25. doi: 10.1016/s0761-8425(06)72084-8.
Hypersensitivity pneumonitis (HP) is a granulomatous disease of the lungs due to immune reactions following chronic inhalation of organic dusts or chemicals especially encountered in the occupational environment. The main purpose of this review is to report current concepts regarding aetiologies, epidemiology, diagnosis, treatment as well as legal aspects of HP.
The following aspects will be focused: (1) increase in new etiological circumstances, especially occupational and news antigens, (2) for diagnosis, the major contribution of chest high resolution CT scan which often shows characteristic images but also recent developments in simple diagnostic criteria that may be used for an epidemiological approach, (3) importance of bronchial obstruction and even emphysema as a long term sequelae, finally (4) the possibility of continuing occupational activities in certain circumstances where preventive measures can be used.
The increasing knowledge of etiological agents and circumstances as well as the development of secondary and especially primary preventive measures should lead to reduce the frequency of this disease and of its medico-social consequences.
过敏性肺炎(HP)是一种肺部肉芽肿性疾病,由长期吸入职业环境中常见的有机粉尘或化学物质后引发的免疫反应所致。本综述的主要目的是报告关于HP的病因、流行病学、诊断、治疗以及法律方面的当前概念。
将重点关注以下几个方面:(1)新的病因情况增加,特别是职业性和新出现的抗原;(2)对于诊断,胸部高分辨率CT扫描的主要贡献,其常显示特征性图像,以及简单诊断标准的最新进展,这些标准可用于流行病学研究;(3)支气管阻塞甚至肺气肿作为长期后遗症的重要性;最后(4)在某些可采取预防措施的情况下继续职业活动的可能性。
对病因和情况的认识不断增加,以及二级特别是一级预防措施的发展,应能降低这种疾病的发病率及其医疗社会后果。