Strâmbu Irina, Belaconi Ionela, Stoicescu Ileana, Ioniţă Diana, Cojocaru Felicia, Niţă Camelia, Dospinoiu Daniela, Bumbăcea Roxana
Pneumologia. 2013 Oct-Dec;62(4):206-11.
Interstitial lung diseases (lLD) are a large group of rare diseases, with difficult diagnosis and management. Very little is known about prevalence, diagnosis and management of ILDs in Romania. This study aims to gather information on how ILDs are diagnosed and managed in Romania, focusing on a tertiary hospital with expertise and equipment needed for accurate diagnosis. We analyzed retrospectively the files of patients admitted with ILD in 2011 in "Marius Nasta" Institute of Pulmonology Bucharest. There were 178 eligible patient files with ILDs and 186 sarcoidosis cases. The ILD diagnosis were: 41 cases idiopathic pulmonary fibrosis (IPF), collagen disease associated ILD (29 cases), hypersensitivity pneumonia (19 cases), alveolar proteinosis (9 cases), cryptogenic organizing pneumonia (9 cases), undefined ILD (46 cases), other (25 cases). The investigations used for the diagnosis were: chest X-ray (100%), spirometry (157pts, 88.21%), diffusion capacity (127 pts, 71.43%, broncho-alveolar lavage (92 pts, 51.69%), CT scan (141 pts, 79.22%), lung biopsy (26 pts, 14.6%), similar to other European centers, but fewer lung biopsies are performed. There is need for a prospective registration of ILD cases in a national registry, for creating local guidelines for diagnosis of ILDs, to improve the suspicion of ILD and referring of patients to specialized centers. Diagnosis can be improved by a multidisciplinary approach of each case, involving the clinician, the radiologist, the pathologist and the thoracic surgeon.
间质性肺疾病(ILD)是一大类罕见疾病,诊断和管理困难。关于罗马尼亚ILD的患病率、诊断和管理知之甚少。本研究旨在收集有关罗马尼亚如何诊断和管理ILD的信息,重点关注一家具备准确诊断所需专业知识和设备的三级医院。我们回顾性分析了2011年在布加勒斯特“马里乌斯·纳斯塔”肺病研究所收治的ILD患者档案。有178份符合条件的ILD患者档案和186例结节病病例。ILD的诊断结果为:41例特发性肺纤维化(IPF)、胶原病相关ILD(29例)、过敏性肺炎(19例)、肺泡蛋白沉积症(9例)、隐源性机化性肺炎(9例)、未明确的ILD(46例)、其他(25例)。用于诊断的检查方法有:胸部X线检查(100%)、肺功能测定(157例,88.21%)、弥散功能检查(127例,71.43%)、支气管肺泡灌洗(92例,51.69%)、CT扫描(141例,79.22%)、肺活检(26例,14.6%),与其他欧洲中心类似,但肺活检的实施较少。需要在国家登记处对ILD病例进行前瞻性登记,制定ILD诊断的本地指南,以提高对ILD的怀疑并将患者转诊至专科中心。通过对每个病例采用多学科方法,包括临床医生、放射科医生、病理科医生和胸外科医生,可改善诊断。