Division of Respiratory Medicine, University of Calgary, Calgary, AB, T1Y 6J4 Canada.
Am J Respir Crit Care Med. 2010 Apr 15;181(8):832-7. doi: 10.1164/rccm.200906-0959OC. Epub 2010 Jan 7.
Idiopathic pulmonary fibrosis (IPF) and other idiopathic interstitial pneumonias (IIPs) have similar clinical and radiographic features, but their histopathology, response to therapy, and natural history differ. A surgical lung biopsy is often required to distinguish between these entities.
We sought to determine if clinical variables could predict a histopathologic diagnosis of IPF in patients without honeycomb change on high-resolution computed tomography (HRCT).
Data from 97 patients with biopsy-proven IPF and 38 patients with other IIPs were examined. Logistic regression models were built to identify the clinical variables that predict histopathologic diagnosis of IPF.
Increasing age and average total HRCT interstitial score on HRCT scan of the chest may predict a biopsy confirmation of IPF. Sex, pulmonary function, presence of desaturation, or distance walked during a 6-minute walk test did not help discriminate pulmonary fibrosis from other IIPs.
Clinical data may be used to predict a diagnosis of IPF over other IIPs. Validation of these data with a prospective study is needed.
特发性肺纤维化（IPF）和其他特发性间质性肺炎（IIP）具有相似的临床和影像学特征，但它们的组织病理学、对治疗的反应和自然病史不同。通常需要进行外科肺活检来区分这些实体。
我们试图确定在高分辨率计算机断层扫描（HRCT）无蜂窝改变的情况下，临床变量是否可以预测 IPF 的组织病理学诊断。
检查了 97 例经活检证实的 IPF 患者和 38 例其他 IIP 患者的数据。建立逻辑回归模型以确定预测 IPF 组织病理学诊断的临床变量。
年龄的增加和胸部 HRCT 扫描的平均总 HRCT 间质评分可能预测活检证实的 IPF。性别、肺功能、低氧血症的存在或 6 分钟步行试验中的行走距离并不能帮助区分肺纤维化与其他 IIP。
临床数据可用于预测 IPF 相对于其他 IIP 的诊断。需要前瞻性研究验证这些数据。
