肌炎相关肺病的诊断与治疗。

Diagnosis and Management of Myositis-Associated Lung Disease.

机构信息

Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.

Division of Pulmonary Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

出版信息

Chest. 2023 Jun;163(6):1476-1491. doi: 10.1016/j.chest.2023.01.031. Epub 2023 Feb 9.

Abstract

Although interstitial lung disease (ILD) is a leading cause of morbidity and mortality in patients with inflammatory myopathies, the current definition and diagnostic criteria of autoimmune myositis remain inadequate to capture the large proportion of patients with lung-dominant disease. As a result, these patients present unique diagnostic and treatment challenges for even the most experienced clinicians. This article highlights the emerging role of autoantibodies in the diagnosis, classification, and management of patients with ILD. We propose alternative nomenclature to facilitate research on this unique patient population. Additionally, evidence supporting the various therapies used in the treatment of myositis-associated ILD is reviewed. The classification and treatment of patients with myositis-associated ILD remains challenging. A standardized therapeutic approach to these patients is lacking, and prospective studies in the field are needed to determine optimal treatment regimens.

摘要

虽然间质性肺病 (ILD) 是导致炎症性肌病患者发病率和死亡率的主要原因,但自身免疫性肌炎的当前定义和诊断标准仍不足以涵盖大部分以肺为主的疾病患者。因此,即使是最有经验的临床医生,这些患者也提出了独特的诊断和治疗挑战。本文强调了自身抗体在ILD 患者的诊断、分类和管理中的新作用。我们提出了替代的命名法,以促进对这一独特患者群体的研究。此外,还回顾了支持用于治疗肌炎相关性 ILD 的各种疗法的证据。肌炎相关性 ILD 患者的分类和治疗仍然具有挑战性。缺乏针对这些患者的标准化治疗方法,需要在该领域进行前瞻性研究,以确定最佳治疗方案。

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