Department of Clinical Medicine and Rheumatology, University Campus Bio-Medico of Rome, Italy.
Autoimmun Rev. 2013 Sep;12(11):1076-84. doi: 10.1016/j.autrev.2013.05.001. Epub 2013 May 15.
The lungs are frequently involved in Connective Tissue Diseases (CTDs). Interstitial lung disease (ILD) is one of the most common pleuropulmonary manifestations that affects prognosis significantly. In practice, rheumatologists and other physicians tend to underestimate the impact of CTD-ILDs and diagnose respiratory impairment when it has reached an irreversible fibrotic stage. Early investigation, through clinical evidence, imaging and - in certain cases - lung biopsy, is therefore warranted in order to detect a possible ILD at a reversible initial inflammatory stage. In this review, we focus on lung injury during CTDs, with particular attention to ILDs, and examine their prevalence, clinical manifestations and histological patterns, as well as therapeutic approaches and known complications till date. Although several therapeutic agents have been approved, the best treatment is still not certain and additional trials are required, which demand more knowledge of pulmonary involvement in CTDs. Our central aim is therefore to document the impact that lung damage has on CTDs. We will mainly focus on Rheumatoid Arthritis (RA), which - unlike other rheumatic disorders - resembles Idiopathic Pulmonary Fibrosis (IPF) in numerous aspects.
肺部经常受到结缔组织疾病（CTD）的影响。间质性肺疾病（ILD）是最常见的胸膜肺表现之一，对预后有重大影响。在实践中，风湿病学家和其他医生往往低估了 CTD-ILD 的影响，并且在呼吸损害已经达到不可逆转的纤维化阶段时才进行诊断。因此，为了在可逆转的初始炎症阶段检测到可能的间质性肺病，通过临床证据、影像学检查和（在某些情况下）肺活检进行早期调查是有必要的。在这篇综述中，我们重点关注 CTD 期间的肺部损伤，特别是间质性肺病，并检查其患病率、临床表现和组织学模式，以及迄今为止的治疗方法和已知并发症。尽管已经批准了几种治疗药物，但最佳治疗方法仍不确定，需要进行更多的试验，这需要更多地了解 CTD 中的肺部受累。因此，我们的主要目的是记录肺部损伤对 CTD 的影响。我们将主要关注类风湿关节炎（RA），它与其他风湿性疾病不同，在许多方面与特发性肺纤维化（IPF）相似。
