Pulmonary Rehabilitation Unit, Fondazione Salvatore Maugeri, Istituto Scientifico di Telese, Telese Terme, Provincia di Benevento, Italy.
Respir Care. 2014 Mar;59(3):e31-4. doi: 10.4187/respcare.02520. Epub 2013 Aug 6.
The diffuse parenchymal lung diseases form a heterogeneous group of disorders characterized by varying degrees of inflammation and fibrosis involving the space between epithelial and endothelial basement membranes. Among the diffuse parenchymal lung diseases of unknown etiology, one of the most common is usual interstitial pneumonia/idiopathic pulmonary fibrosis, which carries the worst prognosis. In contrast, nonspecific interstitial pneumonia, which belongs to the same diffuse parenchymal lung disease group, has a more favorable prognosis. Based on the relative amount of inflammation and fibrosis observed on lung biopsies, at least 2 nonspecific interstitial pneumonia patterns have been suggested: cellular and fibrosing. The long-term prognosis is excellent for patients with nonspecific interstitial pneumonia with a cellular pattern, as compared to patients with a fibrosing pattern. We describe here a patient with nonspecific interstitial pneumonia with a fibrosing pattern in a highly practiced runner, showing an unexpectedly long-term favorable course, and consider the possible role of exercise in the diagnosis and clinical course of the disease. This case reinforces the evidence that exercise training, which is a principal component of pulmonary rehabilitation, may have clinically important effects on functional exercise capacity, especially if it is delivered early in the course of the disease.
弥漫性实质性肺疾病形成了一组异质性疾病，其特征是上皮和内皮基底膜之间的空间存在不同程度的炎症和纤维化。在病因不明的弥漫性实质性肺疾病中，最常见的是特发性间质性肺炎/特发性肺纤维化，其预后最差。相比之下，属于同一弥漫性实质性肺疾病组的非特异性间质性肺炎具有更好的预后。根据肺活检中观察到的炎症和纤维化的相对量，至少已经提出了 2 种非特异性间质性肺炎模式：细胞性和纤维性。与纤维性模式的患者相比，具有细胞性模式的非特异性间质性肺炎患者的长期预后非常好。我们在此描述了一位患有纤维性非特异性间质性肺炎的高度训练有素的跑步者，其病情表现出出乎意料的长期良好过程，并考虑了运动在疾病诊断和临床过程中的可能作用。该病例进一步证实了运动训练的作用，运动训练是肺康复的主要组成部分，它可能对功能运动能力产生重要的临床影响，尤其是在疾病早期实施时。
