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药物诱导的肺病:一个叙事审查
Guilherme das Posses Bridi1,2, Eduardo Kaiser Ururahy Nunes Fonseca3,4, Ronaldo Adib Kairalla1,5
1. Divisao de Pneumologia, Instituto do Coracao (InCor), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo - HCFMUSP - São Paulo (SP) Brasil.
概括
药物诱导性肺病 (DILD) 是一种由各种药物引起的多样性疾病. 早期识别和药物戒断是管理DILD的关键,DILD带来了诊断挑战.
科学领域:
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
- 放射学 放射学是一门学科.
背景情况:
- 药物诱导性肺病 (DILD) 是间歇性肺病的重要原因,占病例的3-5%.
- 它是由暴露于广泛的药物引起的,包括抗瘤药物,DMARDs,抗失常药物和抗生素.
- 病变发生是多因素的,通常是未知的,肺损伤呈现是可变的.
研究的目的:
- 审查药物诱导的肺病的临床表现,诊断挑战和管理.
- 强调在新出现呼吸道症状和药物 anamnesis 的患者考虑 DILD 的重要性.
主要方法:
- 关于药物诱导的肺部疾病的文献综述.
- 分析临床表现,CT成像模式和治疗策略.
- 强调差异诊断和排除其他肺部疾病.
主要成果:
- 大多数情况下,DILD呈现急性,从无症状到呼吸衰竭.
- 常见的CT发现包括地面玻璃不透明,组织性肺炎和扩散性气泡膜损伤.
- 对于DILD来说,没有特定的临床或CT模式是病理标志性的,这会使诊断复杂化.
结论:
- 诊断DILD需要高度的怀疑指数和排除其他原因.
- 停止治疗致病剂是主要的治疗方法,经常补充用皮质类固醇.
- 预后有所不同,严重病例的死亡率很高.
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