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[肺病中的淀粉样变性]

[Amyloidosis in pneumology].

作者信息

Hagmeyer Lars, Stieglitz S, Röcken C, Randerath W

机构信息

Krankenhaus Bethanien gGmbH, Klinik für Pneumologie und Allergologie, Zentrum für Schlaf- und Beatmungsmedizin, Solingen.

出版信息

Pneumologie. 2012 Aug;66(8):483-92. doi: 10.1055/s-0032-1309811. Epub 2012 Jun 12.

DOI:10.1055/s-0032-1309811
PMID:22692971
Abstract

Amyloidosis is a rare disorder within the field of pneumology, however, it is estimated that there are a relevant number of unreported cases. In routine clinical practice, the disease is seldom considered in the diagnostic work-up of unclear respiratory symptoms and radiological findings. For amyloidosis to be considered as a differential diagnosis, the clinician must be aware of the broad variety of its clinical manifestations. In cases where amyloidosis is suspected, it is important to obtain an early tissue biopsy. If the diagnosis can be confirmed by Congo red staining, further subtyping of the amyloid protein is necessary in order to identify a treatable cause of the disease. The amyloidoses are classified according to the type of amyloid protein, with clinical subclassifications distinguishing hereditary from acquired forms and localised from generalised manifestations. Apart from causal therapy of the primary disease, the treatment of generalised amyloidosis includes specific systemic therapy. The majority of localised forms are treated with specific local interventions showing good long-term results. This review outlines the pathophysiology, classification, diagnostic pathways and therapeutic modalities in amyloidosis. Furthermore, typical manifestations of amyloidosis of the lung and the specific treatment options are discussed.

摘要

淀粉样变性是肺病领域的一种罕见疾病,然而,据估计有相当数量的未报告病例。在常规临床实践中,在对不明原因的呼吸道症状和影像学表现进行诊断检查时,很少会考虑到这种疾病。要将淀粉样变性视为鉴别诊断,临床医生必须了解其广泛的临床表现。在怀疑淀粉样变性的病例中,尽早进行组织活检很重要。如果刚果红染色能确诊,为了确定可治疗的病因,有必要对淀粉样蛋白进行进一步的亚型分类。淀粉样变性根据淀粉样蛋白的类型进行分类,临床亚分类将遗传性与获得性形式以及局限性与全身性表现区分开来。除了对原发性疾病进行病因治疗外,全身性淀粉样变性的治疗还包括特定的全身治疗。大多数局限性形式采用特定的局部干预措施进行治疗,长期效果良好。本综述概述了淀粉样变性的病理生理学、分类、诊断途径和治疗方式。此外,还讨论了肺淀粉样变性的典型表现和具体治疗选择。

相似文献

1
[Amyloidosis in pneumology].[肺病中的淀粉样变性]
Pneumologie. 2012 Aug;66(8):483-92. doi: 10.1055/s-0032-1309811. Epub 2012 Jun 12.
2
[Interdisciplinary guidelines on diagnosis and treatment for extracerebral amyloidoses--published by the German Society of Amyloid Diseases (www.amyloid.de)].[《脑外淀粉样变性的诊断与治疗跨学科指南》——由德国淀粉样变性疾病协会(www.amyloid.de)发布]
Dtsch Med Wochenschr. 2006 Jul 7;131(27 Suppl 2):S45-66. doi: 10.1055/s-2006-947836.
3
Diagnostic and therapeutic approach of systemic amyloidosis.系统性淀粉样变性的诊断与治疗方法。
Neth J Med. 2004 Apr;62(4):121-8.
4
Fine-needle aspiration of abdominal fat pad for amyloid detection: a clinically useful test?经细针穿刺腹部脂肪垫检测淀粉样蛋白:一项临床实用的检测方法?
Diagn Cytopathol. 2004 Mar;30(3):178-81. doi: 10.1002/dc.10370.
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The Pathology of Amyloidosis in Classification: A Review.淀粉样变的病理学分类:综述。
Acta Haematol. 2020;143(4):322-334. doi: 10.1159/000506696. Epub 2020 May 11.
6
Immunoglobulin light and heavy chain amyloidosis AL/AH: renal pathology and differential diagnosis.免疫球蛋白轻链和重链淀粉样变性AL/AH:肾脏病理学及鉴别诊断
Contrib Nephrol. 2007;153:135-55. doi: 10.1159/000096765.
7
[Amyloidosis and the respiratory tract].[淀粉样变性与呼吸道]
Acta Med Port. 2009 Jan-Feb;22(1):105-12. Epub 2009 Mar 25.
8
[Diagnosis and treatment in systemic amyloidosis].[系统性淀粉样变性的诊断与治疗]
Rinsho Byori. 2008 Feb;56(2):121-9.
9
The neuromuscular manifestations of amyloidosis.
J Clin Neuromuscul Dis. 2010 Mar;11(3):145-57. doi: 10.1097/CND.0b013e3181d05994.
10
Amyloidosis and the lung.淀粉样变性与肺
Chron Respir Dis. 2006;3(4):203-14. doi: 10.1177/1479972306070066.

引用本文的文献

1
Local vs. systemic pulmonary amyloidosis-impact on diagnostics and clinical management.局部与系统性肺淀粉样变性:对诊断和临床管理的影响。
Virchows Arch. 2018 Nov;473(5):627-637. doi: 10.1007/s00428-018-2442-x. Epub 2018 Aug 22.