Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, 1400 Jackson Street G-10a, Denver, CO 80206, USA.
Chest. 2010 Jan;137(1):129-37. doi: 10.1378/chest.09-1002. Epub 2009 Sep 11.
Limited data exist regarding the population-based epidemiology of idiopathic pulmonary fibrosis (IPF). The objective of the study was to describe the trends in the incidence, prevalence, and clinical course of IPF in the community.
We conducted a population-based study of adult patients with IPF in Olmsted County, Minnesota, from 1997 to 2005. Two methods were used to identify IPF cases, as defined by the 2002 American Thoracic Society/European Respiratory Society consensus statement: (1) usual interstitial pneumonia (UIP) on a surgical lung biopsy specimen or a definite UIP pattern on a high-resolution CT image (narrow criteria) and (2) UIP on a surgical lung biopsy specimen or a definite or possible UIP pattern on CT image (broad criteria).
Of 596 patients screened for the possibility of pulmonary disease or pulmonary fibrosis over 9 years of follow-up, 47 cases had IPF. Of these, 24 met the narrow criteria. The age- and sex-adjusted incidence was 8.8/100,000 and 17.4/100,000 person-years, for narrow and broad criteria, respectively. The age-adjusted incidence was higher in men than in women, and among patients aged 70-79 years. During the study period, the incidence of IPF decreased (P < .001). On December 31, 2005, the age- and sex-adjusted prevalence was 27.9/100,000 and 63/100,000 persons by narrow and broad criteria, respectively. Thirty-seven patients experienced a total of 53 respiratory exacerbations (26 IPF related, 27 non-IPF related), and 34 (72%) patients died. The primary cause of death was IPF related in 16 (47%) patients. Median survival for narrow-criteria and broad-criteria incidence cases was 3.5 and 4.4 years, respectively.
The incidence of IPF in Olmsted County decreased over the study period. Nonprimary IPF respiratory exacerbations are as frequent as primary IPF respiratory exacerbations and an important cause of death.
特发性肺纤维化（IPF）的基于人群的流行病学数据有限。本研究的目的是描述社区中 IPF 的发病率、患病率和临床过程的趋势。
我们对明尼苏达州奥姆斯特德县的成年 IPF 患者进行了一项基于人群的研究，时间范围为 1997 年至 2005 年。使用两种方法来识别 IPF 病例，方法是根据 2002 年美国胸科学会/欧洲呼吸学会共识声明定义的：（1）外科肺活检标本上的普通间质性肺炎（UIP）或高分辨率 CT 图像上的明确 UIP 模式（窄标准）和（2）外科肺活检标本上的 UIP 或 CT 图像上的明确或可能的 UIP 模式（宽标准）。
在 9 年的随访中，对 596 名筛查肺疾病或肺纤维化的患者进行了筛查，其中 47 例患有 IPF。其中，24 例符合窄标准。年龄和性别调整后的发病率分别为 8.8/100,000 和 17.4/100,000 人年，窄和宽标准分别为。男性的年龄调整发病率高于女性，年龄在 70-79 岁之间。在研究期间，IPF 的发病率下降（P <.001）。截至 2005 年 12 月 31 日，年龄和性别调整后的患病率分别为窄标准和宽标准的 27.9/100,000 和 63/100,000 人。37 名患者共经历了 53 次呼吸恶化（26 次与 IPF 相关，27 次与 IPF 不相关），34 名（72%）患者死亡。16 名（47%）患者的主要死亡原因为 IPF 相关。窄标准和宽标准发病病例的中位生存期分别为 3.5 年和 4.4 年。
奥姆斯特德县的 IPF 发病率在研究期间下降。非原发性 IPF 呼吸恶化与原发性 IPF 呼吸恶化一样常见，是死亡的重要原因。
