Spector N M, Connolly M A, Garrity E R
Niehoff School of Nursing, Loyola University, Chicago, III, USA.
Am J Crit Care. 1996 Sep;5(5):366-72.
More centers are performing lung transplants for a variety of pulmonary conditions. Chronic rejection, manifested as obliterative bronchiolitis, is the most common cause of late death (greater than 6 months after transplant) in this population.
To review published literature on obliterative bronchiolitis to determine the current terminology and definition, pathophysiology, incidence, diagnosis, treatment, and outcome of this condition.
A MEDLINE search was done using the medical subject headings of bronchiolitis obliterans and lung transplantation. Studies were selected based on sample size and reporting of obliterative bronchiolitis statistics. Sources that were not data-based discussions also were selected if they were comprehensive reviews or provided insight into relevant issues.
Obliterative bronchiolitis terminology is not used consistently in the literature. It is an obstructive defect that affects the airways, causing progressive occlusion. Diagnosis is based on clinical findings or on histological analysis; early markers are sought, to aid in diagnosis. Incidence of obliterative bronchiolitis varies from 7% to 54%, with a mortality rate of 30% to 40%. Currently, enhanced immunosuppression is the treatment of choice, although research is being carried out to evaluate methods of inhibiting growth factor activity for use in future treatment strategies.
Obliterative bronchiolitis is a common complication in lung transplant recipients, and future research will focus on treatment and early diagnosis. Efforts are under way to standardize nomenclature and reporting of incidence and mortality rates.
越来越多的中心正在针对各种肺部疾病开展肺移植手术。慢性排斥反应表现为闭塞性细支气管炎，是该人群晚期死亡（移植后超过6个月）的最常见原因。
回顾已发表的关于闭塞性细支气管炎的文献，以确定该病症当前的术语和定义、病理生理学、发病率、诊断、治疗及预后。
使用闭塞性细支气管炎和肺移植的医学主题词在MEDLINE数据库进行检索。根据样本量以及闭塞性细支气管炎统计数据的报告情况选择研究。若为全面综述或能深入探讨相关问题，非基于数据讨论的资料也会被选用。
文献中闭塞性细支气管炎的术语使用并不一致。它是一种影响气道的阻塞性缺陷，导致渐进性闭塞。诊断基于临床发现或组织学分析；正在寻找早期标志物以辅助诊断。闭塞性细支气管炎的发病率在7%至54%之间，死亡率为30%至40%。目前，强化免疫抑制是首选治疗方法，不过正在开展研究以评估抑制生长因子活性的方法用于未来的治疗策略。
闭塞性细支气管炎是肺移植受者的常见并发症，未来研究将聚焦于治疗和早期诊断。目前正在努力规范命名以及发病率和死亡率的报告。
