间质性肺疾病概要1.pptVIP

* * 大量研究表明，UIP表现的HRCT对于病理诊断UIP具有高度特异性，因此在除外其他继发因素后，可诊断IPF。 * * Figure 1. High-resolution computed tomography (HRCT) images demonstrating usual interstitial pneumonia (UIP) pattern and possible UIP pattern. (A and B) UIP pattern, with extensive honeycombing: axial and coronal HRCT images show basal predominant, peripheral predominant reticular abnormality with multiple layers of honeycombing (arrows). (C and D) UIP pattern, with less severe honeycombing: axial and coronal CT images show basal predominant, peripheral predominant reticular abnormality with subpleural honeycombing (arrows). (E and F ) Possible UP pattern: axial and coronal images show peripheral predominant, basal predominant reticular abnormality with a moderate amount of ground glass abnormality, but without honeycombing. * Surgical lung biopsy specimens demonstrating UIP pattern. (A) Scanning power microscopy showing a patchy process with honeycomb spaces (thick arrow), some preserved lung tissue regions (thin arrow), and fibrosis extending into the lung from the subpleural regions. (B) Adjacent to the regions of more chronic fibrosis (thick arrow) is a fibroblast focus (asterisk), recognized by its convex shape and composition of edematous fibroblastic tissue, suggestive of recent lung injury. * * 在接受多个肺叶活检的患者中，12-26%同时存在UIP和NSIP，但此类不一致性的UIP与一致性的UIP预后无差别。 * Survival in treated vs untreated patients. Kaplan-Meier survival curves for patients treated with corticosteroid and cyclophosphamide therapy (thin black line; n = 82), patients not treated (thick gray line; n = 82), and the expected survival of 68-year-olds in the general US population (thin gray line). Circles and squares represent censored observations. the mean length of survival from the time of diagnosis varied between 3.2 and 5 yr In another study, the median survival was 28.2 mo from the onset of respiratory symptoms POTENTIAL RISK FACTORS Cigarette Smoking Exposure to Commonly Prescribed Drugs Chronic Aspiration Environmental Factors