小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 呼吸困难
- 咳嗽
- 爆裂音
其他诊断因素
- 体重减轻、疲劳和乏力
- 杵状指
危险因素
- 高龄
- 男性
- 家族史
- 吸烟
- 有机和无机粉尘暴露
- 胃食管反流
- 感染
- 糖尿病
诊断性检查
首要检查
- 胸部 X 线检查 (CXR)
- 高分辨率CT(HRCT)
- 抗核抗体（免疫荧光检测）
- 类风湿因子
- 抗环瓜氨酸肽
- 肌炎全套检查
需考虑的检查
- 肺功能检查 (PFT)
- 外科肺活检
- 支气管肺泡灌洗 (bronchoalveolar lavage, BAL)
- 经支气管活检
- C 反应蛋白 (CRP)
- 红细胞沉降率 (ESR)
治疗流程
急性加重
目前未出现急性加重的患者
撰稿人
作者
Mary Elizabeth Kreider, MD, MS
Associate Professor of Clinical Medicine
Pulmonary, Allergy, and Critical Care Division
Perelman School of Medicine
University of Pennsylvania
Philadelphia
PA
利益声明
MEK is serving as site principal investigator for Bellerophon and United Therapeutics for interstitial lung disease (ILD) studies. Her institution receives payments for those trials.
Jake G. Natalini, MD
Fellow
Pulmonary, Allergy, and Critical Care Division
Perelman School of Medicine
University of Pennsylvania
Philadelphia
PA
利益声明
JGN declares that he has no competing interests.
鸣谢
Dr Mary Elizabeth Kreider and Dr Jake G. Natalini would like to gratefully acknowledge Dr Judd David Flesch, Dr Gregory Tino, and Dr Jeffrey C. Munson, previous contributors to this topic.
利益声明
GT has served as a consultant for InterMune. GT has served as a principal investigator for clinical trials in idiopathic pulmonary fibrosis. JDF amd JCM declare that they have no competing interests.
同行评议者
Stephen Nathan, MD
Medical Director
Lung Transplant & Advanced Lung Disease Program
Inova Fairfax Hospital
Falls Church
VA
利益声明
SN is an author of a reference cited in this monograph.
Athol Wells, MD, FRCP
Professor of Respiratory Medicine
Interstitial Lung Disease Unit
Royal Brompton Hospital
London
UK
利益声明
AW declares that he has no competing interests.
鉴别诊断
- 非特异性间质性肺炎
- 隐源性机化性肺炎
- 急性间质性肺炎 (AIP)
更多 鉴别诊断指南
- 成人特发性肺纤维化（更新）和进行性肺纤维化：ATS/ERS/JRS/ALAT 官方临床实践指南
- 成人慢性肺疾病家庭氧疗
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