在诊断间歇性肺部疾病之前,描述患者途径
Caitlin C Fermoyle1,2, John Townend3, Vidya Navaratnam4,5
1The University of Sydney, Faculty of Medicine and Health, Sydney, Australia.
Respirology (Carlton, Vic.)
|March 12, 2026
概括
间歇性肺部疾病 (ILD) 通常在诊断前长达10年的时间内呈现逐渐的,非特异性的症状,如咳和呼吸障碍. 在初级保健中提高认识可以改善ILDs的早期检测和治疗.
科学领域:
- 肺部医学 肺部医学
- 诊断医学 诊断医学 诊断医学
- 流行病学 流行病学
背景情况:
- 间歇性肺部疾病 (ILD) 显著影响生活质量和生存,诊断往往发生迟.
- 晚期诊断限制了治疗的有效性,因为肺损伤可能是不可逆转的.
- 早期检测对于保持肺功能和改善患者的治疗结果至关重要.
研究的目的:
- 为了识别早期的迹象,症状和健康状况,先前的间歇性肺部疾病 (ILD) 诊断.
- 为了确定在ILD诊断前几年出现症状的时间表.
主要方法:
- 利用英国大型初级保健电子医疗记录数据库来识别发生的ILD病例.
- 对比了ILD患者的症状,征兆和健康状况的患病率和时间,与诊断前10年的匹配对照.
主要成果:
- 与对照组 (N=60,156) 相比,ILD患者 (N=18,914) 更频繁地表现出呼吸不良,咳,疲劳,体重减轻和食欲丧失等症状.
- 73%的ILD患者在初级保健诊所出现咳或喘息,其中13%-17%的患者经历了≥5次症状.
- 在诊断前10年内,在ILD患者中观察到咳和呼吸障碍的发病率增加,几率比率在诊断更接近时显著上升.
- 很高比例的ILD患者最初被误诊为其他呼吸系统疾病 (95%-97%) 或心力衰竭 (4%-9%).
结论:
- 延迟的ILD诊断是由于非特异性症状的逐渐发作和频繁的误诊造成的.
- 在初级保健从业者中提高对ILD的认识对于早期诊断至关重要.
- 缩短诊断时间线可以加速获得重要的ILD治疗.
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