引用本文:韩 茜,罗 群.肺活检在特发性肺纤维化诊断中的应用[J].中国临床新医学,2021,14(4):345-349.
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肺活检在特发性肺纤维化诊断中的应用
韩 茜,罗 群
510120 广东,广州医科大学附属第一医院广州呼吸健康研究院呼吸疾病国家重点实验室/国家呼吸系统疾病临床医学研究中心
摘要:
[摘要] 特发性肺纤维化(IPF)是特发性间质性肺疾病中最常见、预后最差的类型。早诊早治是改善患者预后的关键措施。对于胸部高分辨率CT(HRCT)表现不是典型的普通型间质性肺炎(UIP)时,通常需要进行肺活检辅助诊断。外科肺活检可获取到足够的样本,是获得肺组织学样本的金标准。但外科肺活检可能导致IPF患者病情急性加重,甚至死亡。冷冻肺活检可获得较大体积、保存良好的肺组织和较好的诊断率,且患者死亡风险也比外科肺活检更低,因此可能是外科肺活检的替代方案,但仍需要进一步的研究证实。传统的经支气管镜肺活检和经皮穿刺肺活检因其固有的局限性,现基本不应用于IPF临床诊断中。
关键词:  特发性肺纤维化  外科肺活检  冷冻肺活检
DOI:10.3969/j.issn.1674-3806.2021.04.04
分类号:R 563
基金项目:广州呼吸健康研究院临床自主探索项目(编号:2019GIRHZ05);国家重点研发计划课题(编号:2016YFC0905701)
Application of lung biopsy in diagnosis of idiopathic pulmonary fibrosis
HAN Qian, LUO Qun
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangdong 510120, China
Abstract:
[Abstract] Idiopathic pulmonary fibrosis(IPF) is the most common type of idiopathic interstitial lung diseases and has the worst prognosis.Early diagnosis and early treatment are the key measures to improve the patients′ prognoses.Lung biopsy is usually required to assist diagnosis when the findings on chest high-resolution computed tomography(HRCT) are not typical “usual interstitial pneumonia(UIP) pattern”. Surgical lung biopsy(SLB) can obtain enough samples, and is the gold standard for obtaining lung histological samples. However, SLB may results in acute exacerbation of IPF and even death. Trans-bronchial lung cryobiopsy(TBLC) can be an alternative to SLB, because it can get large volume samples, well-preserved lung tissues and relatively high diagnosis rate, and its risk of death is lower than that of SLB. However, further studies are required to confirm these findings. Traditional transbronchial lung biopsy and percutaneous lung biopsy have inherent limitations, so they are rarely used in the clinical diagnosis of IPF.
Key words:  Idiopathic pulmonary fibrosis(IPF)  Surgical lung biopsy(SLB)  Trans-bronchial lung cryobiopsy(TBLC)