闭塞性细支气管炎研究进展
Research progress of bronchiolitis obliterans
闭塞性细支气管炎是一种少见的严重COPD,与小气道损伤相关.总体预后不良,病死率高.可继发于严重感染、ALI、异体移植、药物不良反应、有毒物质吸入及自身免疫疾病.该病起病隐袭,临床症状和体征常呈非特异性,容易造成误诊、漏诊.病程早期阶段是临床治疗的关键时期,部分病例预后不良与延迟诊断发生不可逆的气道纤维化有关.多数患者的早期症状为逐渐进展的呼吸困难,常伴有咳嗽、喘息,肺部的湿啰音及哮鸣音是常见的体征;少数患者无明显症状,单纯表现为肺功能异常.随着医疗水平的提高,各种移植术后患者增多,闭塞性细支气管炎的患者也随之增多.现对其发病机制、临床表现、治疗策略等进行综述,提高临床医生对其认识,早期诊断及治疗,阻断疾病的进程,改善患者的预后,提高生存率.
更多Bronchiolitis obliterans is a rare severe chronic obstructive pulmonary disease ,associated with small airways injury .Most cases show poor prognosis and the mortality is high .It may be secondary to severe infection ,acute lung injury ,allogeneic transplantation ,adverse drug reaction ,toxic substances inhaled and autoimmune diseases .The disease is insidious onset with non-specific symptoms and signs , easily causing missed diagnosis and misdiagnosis .Early stage is the critical period of clinical treatment . Some patients with poor prognosis are associated with delayed diagnosis and irreversible airway fibrosis , Most early symptoms include progressive dyspnea ,often accompanied by cough ,wheezing ,lung rales and wheezing .A few of patients had no obvious symptom ,simply manifested as abnormal lung function .With the improvement of medical advances , transplant patients increased , and patients with bronchiolitis obliterans also increased .We reviewed the pathogenesis ,clinical manifestations and treatment strategies to improve the clinician′s understanding ,in order to achieve early diagnosis and treatment ,block the disease process ,improve the prognosis and survival rate .
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