系统性硬化症相关的间歇性肺病:我们所知道的以及如何将指导方针纳入临床实践.
Anthony J Esposito1, Kavitha C Selvan1, Carrie Richardson2
1Division of Pulmonary and Critical Care, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
系统性硬化症 - 间歇性肺病 (SSc-ILD) 的管理是复杂的. 本综述综合了查和治疗的指导方针,强调了mycophenolate作为SSc-ILD强烈推的治疗方法.
科学领域:
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
- 临床实践指南 临床实践指南
背景情况:
- 间歇性肺病 (ILD) 影响系统性硬化症 (SSc) 患者的很大一部分,是导致死亡的主要原因.
- 治疗选择有限,临床实践指南对比,使SSc-ILD管理复杂化.
- 最近的指导方针为SSc-ILD的治疗提供了不同的观点,这给临床医生带来了挑战.
研究的目的:
- 综合有关SSc-ILD管理的现有证据.
- 为指导SSc-ILD最近临床实践指南的实际应用.
- 为SSc-ILD的查和治疗决策提供一个框架.
主要方法:
- 随机对照试验 (RCT) 和临床实践指南的审查.
- 关于SSc-ILD的查协议的证据综合.
- 基于指南建议的SSc-ILD治疗选择的评估.
主要成果:
- 高分辨率计算机断层扫描 (HRCT) 建议用于初始SSc-ILD查,对于高风险患者或出现新症状的患者建议重新查.
- 酸是SSc-ILD强烈推的唯一疗法,尽管大多数治疗方法的证据质量较低.
- 指导方针有条件地建议使用mycophenolate,tocilizumab,rituximab,cyclophosphamide和nintedanib. 这三种药物均可使用.
结论:
- 评估了当前的SSc-ILD诊断和治疗方法.
- 识别了知识上的差距,为未来的研究铺平了道路.
- 为SSc-ILD诊断和治疗提出了一种精确指导的方法.
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