a Interstitial Lung Disease Unit , Royal Brompton Hospital , London , UK.
Expert Rev Respir Med. 2019 Jul;13(7):645-658. doi: 10.1080/17476348.2019.1632196. Epub 2019 Jul 5.
: Interstitial lung diseases (ILDs) represent a heterogeneous group of rare disorders that include more than 200 entities, mostly associated with high mortality. In recent years, the progress regarding the understanding of the pathogenesis of these diseases led to the approval of specific treatments. In ILDs, the presence of comorbidities has a significant impact on the quality of life and the survival of patients and, therefore, their diagnosis and treatment has a pivotal role in management and could improve overall outcome. : We discuss key diagnostic issues with regard to the most frequent comorbidities in ILDs. Treatment options are also discussed as the decision to investigate more definitively in order to identify specific comorbidities (including lung cancer, pulmonary hypertension, GE reflux, and obstructive sleep apnoea) is critically dependent upon whether comorbidity-specific treatments are likely to be helpful in individual patients, judged on a case by case basis. : The extent to which clinicians proactively pursue the identification of comorbidities depends on realistic treatment goals in individual patients.
间质性肺疾病(ILDs)代表了一组异质性的罕见疾病,其中包括 200 多种疾病实体,大多数与高死亡率相关。近年来,对这些疾病发病机制的认识取得了进展,导致了特定治疗方法的批准。在ILDs 中,合并症的存在对患者的生活质量和生存产生重大影响,因此,对其进行诊断和治疗在管理中起着关键作用,并可以改善整体预后。我们讨论了与ILDs 中最常见合并症相关的关键诊断问题。还讨论了治疗选择,因为确定是否需要更明确地调查以识别特定合并症(包括肺癌、肺动脉高压、胃食管反流和阻塞性睡眠呼吸暂停)的决策取决于特定于合并症的治疗方法是否可能对个别患者有帮助,这需要具体情况具体分析。临床医生主动识别合并症的程度取决于个别患者的现实治疗目标。