Balamugesh T, Behera D
Department of Pulmonary Medicine, Christian Medical College, Vellore, Tamil Nadu.
J Assoc Physicians India. 2007 May;55:363-70.
Idiopathic pulmonary fibrosis (IPF) is being more frequently diagnosed in India, due to its increased awareness, better availability of computed tomography (CT) and fiberoptic bronchoscopy. IPF has the histological appearance of usual interstitial pneumonia (UIP) on surgical lung biopsy. Recent research has given a new insight into the etiology of the disease. Clinical criteria have been specified for presumptive diagnosis of IPF and distinguishing IPF from other conditions. The conventional therapy has been steroids and immunosuppressive agents. But only a minority of patients respond to such a therapy. Immunomodulators (interferon Y1b), antioxidants (Acetyl cysteine) and antifibrotic agents (like pirfenidone) are being studied as novel therapies in this, otherwise, fatal condition. Lung transplantation is the only hope for those patients who show progressive deterioration on medical treatment. Living-donor lobar lung transplantation has been developed as a procedure for patients considered too ill to await cadaveric lung transplantation.
由于对特发性肺纤维化(IPF)的认识提高、计算机断层扫描(CT)和纤维支气管镜检查的可及性增强,印度对其诊断愈发频繁。IPF在外科肺活检时具有普通间质性肺炎(UIP)的组织学表现。最近的研究为该疾病的病因提供了新见解。已明确了IPF的疑似诊断及与其他病症鉴别的临床标准。传统治疗方法为使用类固醇和免疫抑制剂。但只有少数患者对这种治疗有反应。免疫调节剂(干扰素γ1b)、抗氧化剂(乙酰半胱氨酸)和抗纤维化药物(如吡非尼酮)正作为这种致命疾病的新型疗法进行研究。肺移植是那些接受药物治疗后病情逐渐恶化患者的唯一希望。活体供体肺叶移植已被开发出来,用于那些病情过重无法等待尸体肺移植的患者。