Sengül Bilal, Uzun Oğuz, Findik Serhat, Atici Atilla Güven, Erkan Levent
Department of Chest Diseases, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Tuberk Toraks. 2009;57(3):314-26.
Interstitial lung diseases (ILD) include many acute and chronic pulmonary disorders. We aimed to evaluate the patients diagnosed as ILD in our clinic. Between January 2000 and August 2004, 92 patients were included in the study. Fifty eight (63%) of our patients were female, 34 (37%) were male and the median age was 50.2 + or - 14.2 (19-80) years. The most frequent diagnoses were sarcoidosis in females, and IPF in males. The diagnostic methods used were as follows; clinically and radiologically in 36 (39.1%) patients, bronchoscopy in 33 (34.8%) patients, mediastinoscopy in 10 (10.9%) patients, open lung biopsy in 8 (8.7%) patients, skin biopsy in 2 (2.2%), oral mucosal biopsy in 1 (1.1%), lymph node biopsy in 1 (1.1%), renal biopsy in 1 (1.1%) and pleural fluid examination in 1 (1.1%). Bronchoscopic biopsies were diagnostic in 60.9% of sarcoid patients. Twelve (48%) IPF patients had an occupational toxic exposure history. Medical treatment were given to 80 patients. There were good clinical and radiological response in patients with sarcoidosis (96.9%) and cryptogenic organizing pneumonia (COP) (85.7%), however disease was stable in CTD patients and only three of idiopathic pulmonary fibrosis (IPF) patients (15.7%) responded to treatment. In IPF patients, diagnosis was established medially 35.7 months later after the first symptom appeared. Two of the IPF patients had also lung cancer. Treatment related complications occurred in six patients. Fourteen patients died during the follow-up period and eight were IPF. ILD is frequently encountered in general practice of pulmonary physicians and should be considered in differential diagnosis during routine pulmonology clinic. Sarcoidosis and IPF were the most commonly seen diseases. Although ILD is a difficult challenge to diagnose in clinical practice, it may be diagnosed by means of clinical features, radiologic techniques and several biopsy procedures.
间质性肺疾病（ILD）包括许多急性和慢性肺部疾病。我们旨在评估在我们诊所被诊断为ILD的患者。2000年1月至2004年8月期间，92例患者纳入本研究。我们的患者中58例（63%）为女性，34例（37%）为男性，中位年龄为50.2±14.2（19 - 80）岁。女性最常见的诊断是结节病，男性是特发性肺纤维化（IPF）。使用的诊断方法如下：36例（39.1%）患者采用临床和放射学诊断，33例（34.8%）患者采用支气管镜检查，10例（10.9%）患者采用纵隔镜检查，8例（8.7%）患者采用开胸肺活检，2例（2.2%）患者采用皮肤活检，1例（1.1%）患者采用口腔黏膜活检，1例（1.1%）患者采用淋巴结活检，1例（1.1%）患者采用肾活检，1例（1.1%）患者采用胸腔积液检查。支气管镜活检对60.9%的结节病患者具有诊断价值。12例（48%）IPF患者有职业性毒物接触史。80例患者接受了药物治疗。结节病（96.9%）和隐源性机化性肺炎（COP）（85.7%）患者有良好的临床和放射学反应，然而结缔组织病（CTD）患者病情稳定，特发性肺纤维化（IPF）患者中只有3例（15.7%）对治疗有反应。在IPF患者中，首次症状出现后平均35.7个月确诊。2例IPF患者还患有肺癌。6例患者出现治疗相关并发症。随访期间14例患者死亡，8例为IPF。ILD在肺科医生的日常诊疗中经常遇到，在常规肺科门诊的鉴别诊断中应予以考虑。结节病和IPF是最常见的疾病。虽然ILD在临床实践中诊断具有挑战性，但可通过临床特征、放射学技术和多种活检程序进行诊断。
