Ji Xiao-Qing, Wang Li-Xia, Lu De-Gan
Xiao-Qing Ji, De-Gan Lu, Department of Respiratory Medicine, Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong Province, China.
World J Gastroenterol. 2014 Oct 7;20(37):13501-11. doi: 10.3748/wjg.v20.i37.13501.
Extraintestinal manifestations of inflammatory bowel disease (IBD) are a systemic illness that may affect up to half of all patients. Among the extraintestinal manifestations of IBD, those involving the lungs are relatively rare and often overlooked. However, there is a wide array of such manifestations, spanning from airway disease to lung parenchymal disease, thromboembolic disease, pleural disease, enteric-pulmonary fistulas, pulmonary function test abnormalities, and adverse drug reactions. The spectrum of IBD manifestations in the chest is broad, and the manifestations may mimic other diseases. Although infrequent, physicians dealing with IBD must be aware of these conditions, which are sometimes life-threatening, to avoid further health impairment of the patients and to alleviate their symptoms by prompt recognition and treatment. Knowledge of these manifestations in conjunction with pertinent clinical data is essential for establishing the correct diagnosis and treatment. The treatment of IBD-related respiratory disorders depends on the specific pattern of involvement, and in most patients, steroids are required in the initial management. Corticosteroids, both systemic and aerosolized, are the mainstay therapeutic approach, while antibiotics must also be administered in the case of infectious and suppurative processes, whose sequelae sometimes require surgical intervention.
炎症性肠病(IBD)的肠外表现是一种全身性疾病,可能影响多达半数的患者。在IBD的肠外表现中,累及肺部的表现相对少见且常被忽视。然而,这类表现多种多样,涵盖从气道疾病到肺实质疾病、血栓栓塞性疾病、胸膜疾病、肠肺瘘、肺功能测试异常以及药物不良反应等。IBD在胸部的表现范围广泛,且这些表现可能与其他疾病相似。尽管不常见,但治疗IBD的医生必须了解这些有时会危及生命的情况,以避免患者健康进一步受损,并通过及时识别和治疗缓解其症状。了解这些表现并结合相关临床数据对于确立正确的诊断和治疗至关重要。IBD相关呼吸系统疾病的治疗取决于具体的受累模式,在大多数患者中,初始治疗需要使用类固醇。全身性和雾化吸入的皮质类固醇是主要的治疗方法,而在感染性和化脓性过程中还必须使用抗生素,其后遗症有时需要手术干预。