Carrington C B, Gaensler E A, Coutu R E, FitzGerald M X, Gupta R G
N Engl J Med. 1978 Apr 13;298(15):801-9. doi: 10.1056/NEJM197804132981501.
Patients with confirmed interstitial pneumonia were initially classified histologically into "desquamative" (n = 40) and "usual" (n = 53) types, and followed for one to 22 years. Both the diagnosis and the extent of fibrosis affected the course and response to therapy. Mortality in desquamative interstitial pneumonia was 27.5 per cent, and mean survival 12.2 years, as compared with 66.0 per cent and 5.6 years in usual interstitial pneumonia (P less than 0.01). Without treatment, 21.9 per cent with the desquamative but none with the usual type improved. With corticosteroid therapy, 61.5 per cent with desquamative and only 11.5 per cent with usual interstitial pneumonia improved, whereas 27.0 per cent and 69.2 per cent worsened. We conclude that the histologic classification of chronic interstitial pneumonia used here permits forecasts of prognosis and response to treatment that cannot be deduced from other data.
确诊为间质性肺炎的患者最初在组织学上被分为“脱屑性”（40例）和“普通型”（53例），并随访1至22年。纤维化的诊断和范围均影响病程及对治疗的反应。脱屑性间质性肺炎的死亡率为27.5%，平均生存期为12.2年，而普通间质性肺炎的死亡率为66.0%，平均生存期为5.6年（P<0.01）。未经治疗时，21.9%的脱屑性患者病情改善，而普通型患者无一例改善。使用皮质类固醇治疗时，61.5%的脱屑性患者和仅11.5%的普通间质性肺炎患者病情改善，而病情恶化的比例分别为27.0%和69.2%。我们得出结论，此处使用的慢性间质性肺炎的组织学分类有助于预测预后及对治疗的反应，而这是无法从其他数据中推断出来的。
