Hoffmann Tobias, Oelzner Peter, Teichgräber Ulf, Franz Marcus, Gaßler Nikolaus, Kroegel Claus, Wolf Gunter, Pfeil Alexander
Department of Internal Medicine III, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany.
Institute of Diagnostic and Interventional Radiology, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany.
Front Med (Lausanne). 2023 Jan 11;9:1101448. doi: 10.3389/fmed.2022.1101448. eCollection 2022.
Lung involvement is the most common and serious organ manifestation in patients with inflammatory rheumatic disease (IRD). The type of pulmonary involvement can differ, but the most frequent is interstitial lung disease (ILD). The clinical manifestations of IRD-ILD and severity can vary from subclinical abnormality to dyspnea, respiratory failure, and death. Consequently, early detection is of significant importance. (PFT) including diffusing capacity of the lungs for carbon monoxide (DLCO), and (FVC) as well as high-resolution computed tomography (HRCT) are the standard tools for screening and monitoring of ILD in IRD-patients. Especially, the diagnostic accuracy of HRCT is considered to be high. Magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) allow both morphological and functional assessment of the lungs. In addition, biomarkers (e.g., , or MUC5B) are being currently evaluated for the detection and prognostic assessment of ILD. Despite the accuracy of HRCT, invasive diagnostic methods such as (BAL) and lung biopsy are still important in clinical practice. However, their therapeutic and prognostic relevance remains unclear. The aim of this review is to give an overview of the individual methods and to present their respective advantages and disadvantages in detecting and monitoring ILD in IRD-patients in the clinical routine.
肺部受累是炎症性风湿性疾病（IRD）患者最常见且最严重的器官表现。肺部受累的类型可能不同，但最常见的是间质性肺疾病（ILD）。IRD-ILD的临床表现及严重程度各异，从亚临床异常到呼吸困难、呼吸衰竭及死亡都有可能。因此，早期检测至关重要。肺功能测试（PFT），包括肺一氧化碳弥散量（DLCO）和用力肺活量（FVC），以及高分辨率计算机断层扫描（HRCT）是筛查和监测IRD患者ILD的标准工具。特别是，HRCT的诊断准确性被认为很高。磁共振成像（MRI）和正电子发射断层扫描/计算机断层扫描（PET/CT）可对肺部进行形态学和功能评估。此外，目前正在评估生物标志物（如 、 或MUC5B）用于ILD的检测和预后评估。尽管HRCT具有准确性，但诸如支气管肺泡灌洗（BAL）和肺活检等侵入性诊断方法在临床实践中仍很重要。然而，它们的治疗和预后相关性仍不明确。本综述的目的是概述各种方法，并介绍它们在临床常规中检测和监测IRD患者ILD时各自的优缺点。
