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ID:5470634
大小:306.00 KB
页数:36页
时间:2017-12-13
《ipf-idiopathic pulmonary fibrosis》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、IdiopathicPulmonaryFibrosis(IPF)Dr.CheWanAminud-DinbinHashimDepartmentofInternalMedicineSchoolofMedicalSciencesUSMHealthCampusKubangKerian,KelantanDefinitioncryptogenicfibrosingalveolitisfamilyofidiopathicpneumoniassharingtheclinicalfeaturesof-shortnessofbreath-radiographic
2、allyevidentdiffusepulmonaryinfiltrates-varyingdegreesofinflammation,fibrosisorbothonbiopsyDefinitionolderstudiesincludedseveralformsofidiopathicinterstitialpneumoniaundertheterm"idiopathicpulmonaryfibrosis”"idiopathicpulmonaryfibrosis"shouldbereservedforpatientswithaspecifi
3、cformoffibrosinginterstitialpneumoniareferredtoasusualinterstitialpneumoniaKatzensteinetalAmJRespirCritCareMed1998HistopathologicalFeaturesDiagnosisexertionaldyspnoeaandnonproductivecoughMichaelsonJEetalChest2000fifthandsixthdecadesmorecommoninmenthanwomenlow-gradefeverandm
4、yalgia(uncommon)treatmentforotherailments(bronchitis,asthma,orheartfailure)PathogenesisPathogenesiscigarettesmokinghasbeenstronglyassociatedwithidiopathicpulmonaryfibrosiscigarettesmokingmaybeanindependentriskfactorforIPFHanleyMEetalAmRevRespirDis1991noworkplaceorenvironmen
5、talfactorhasbeenclearlylinkedtothedevelopmentofIPFBaumgardnerKBetalAmJEpidemiol2000Diagnosisdetailedoccupationalhistoryexposuretoasbestos,silicaorotherrespirabletoxinstoruleoutpneumoconiosisthatmaymimicidiopathicpulmonaryfibrosisDiagnosisfinebibasilarinspiratorycracklesclub
6、bing(50%)pulmonaryhypertensionandcorpulmonale(late)Diagnosismildanaemiaincreasesinmarkersofsystemicinflammation(ESRorC-reactiveproteinlevel)nonspecificincreasesinrheumatoidfactorandantinuclearantibodies(30%patients)MichaelsonJEChest2000DiagnosisPulmonaryfunctiontestRestrict
7、iveventilatorydefectReducedtotallungcapacity,functionalresidualcapacityandresidualvolumeDecreasedcarbonmonoxidediffusioncapacityChestradiographbilateralreticularopacitiesthataremostprominentintheperipheryofthelungsandinthelowerlobesMathiesonJRetalRadiology1989progressivefib
8、rosisleadstocysticdilatationofthedistalairspaces,whichisvisibleasperipheral"honeyc
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