Interstitial Lung Disease Unit, Respiratory Medicine Department, Wythenshawe Hospital, Manchester, UK.
Barnet Hospital, Royal Free London NHS Foundation Trust, London UK.
Br J Hosp Med (Lond). 2021 Jul 2;82(7):1-14. doi: 10.12968/hmed.2020.0556. Epub 2021 Jul 20.
Interstitial lung diseases are a complex group of conditions that cause inflammation and scarring of the lung interstitium. This article discusses the diagnosis and management of common interstitial lung diseases including idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, connective tissue disease associated-interstitial lung disease, sarcoidosis and drug-induced interstitial lung disease. A multidisciplinary approach to diagnosis of interstitial lung disease is the gold standard; key history and examination features, blood panel, pulmonary function tests, high resolution computed tomography imaging, and when required bronchoalveolar lavage and lung biopsy results are discussed to reach a multidisciplinary consensus diagnosis. Advances, including the development of the disease-modifying anti-fibrotic medications nintedanib and pirfenidone, continue to shape the future management of interstitial lung disease. A holistic approach to the care of patients with interstitial lung disease is paramount, as they often have a high symptom burden and considerable palliative care needs.
间质性肺疾病是一组复杂的疾病,可导致肺间质炎症和瘢痕形成。本文讨论了常见间质性肺疾病的诊断和治疗,包括特发性肺纤维化、过敏性肺炎、结缔组织病相关间质性肺疾病、结节病和药物性间质性肺疾病。多学科方法是间质性肺疾病诊断的金标准;关键的病史和检查特征、血液检查、肺功能检查、高分辨率计算机断层成像,以及在需要时的支气管肺泡灌洗和肺活检结果,都进行了讨论,以达成多学科共识诊断。包括抗纤维化药物尼达尼布和吡非尼酮在内的进展继续塑造间质性肺疾病的未来治疗方法。对间质性肺疾病患者进行全面关怀至关重要,因为他们通常有较高的症状负担和大量的姑息治疗需求。