Inflammatory bowel disease (IBD) has been associated with either clinical or subclinical airway and parenchymal lung involvement and interstitial lung complications. Several studies have reported that atopy has a high...Inflammatory bowel disease (IBD) has been associated with either clinical or subclinical airway and parenchymal lung involvement and interstitial lung complications. Several studies have reported that atopy has a high prevalence in IBD patients. Overlapping allergic disorders seem to be present in both the respiratory and gastrointestinal systems. The purpose of this review is to update clinicians on recent available literature and to discuss the need for a highly suspicious approach by clinicians.展开更多
Primary biliary cirrhosis (PBC) is a chronic progressive cholestatic liver disease caused by diffuse inflammation,destruction and fibrosis of the intrahepatic bile ducts,ultimately leading to cirrhosis,portal hyperten...Primary biliary cirrhosis (PBC) is a chronic progressive cholestatic liver disease caused by diffuse inflammation,destruction and fibrosis of the intrahepatic bile ducts,ultimately leading to cirrhosis,portal hypertension and liver failure.The pathogenesis of PBC is incompletely understood,but current data suggest roles for genetic susceptibility and environmental factors.PBC is often thought of as an organ-specific autoimmune disease,which mainly targets the liver;however,lung tissue is also a site for autoimmune involvement of PBC.The pulmonary manifestations of PBC include abnormalities in gas transfer and pulmonary function,subclinical alveolitis,interstitial lung disease,granulomatous lung disease,airway disease,pulmonary hypertension,pulmonary hemorrhage and pleural effusion.展开更多
目的探讨显微镜下多血管炎(MPA)合并肺部疾病患者的临床特点。方法选取2009年6月至2018年7月首都医科大学附属北京安贞医院收治的MPA合并肺部疾病患者60例,回顾性分析患者的一般资料、临床表现、实验室检查和胸部CT、肺功能、肾脏病理...目的探讨显微镜下多血管炎(MPA)合并肺部疾病患者的临床特点。方法选取2009年6月至2018年7月首都医科大学附属北京安贞医院收治的MPA合并肺部疾病患者60例,回顾性分析患者的一般资料、临床表现、实验室检查和胸部CT、肺功能、肾脏病理、治疗及转归等临床资料。结果 60例患者中男38例、女22例,发病年龄40～88岁,平均(69±11)岁,30例以肺部症状为首发表现,临床表现为咳嗽、咳痰42例,咯血13例,呼吸困难24例。抗髓过氧化物酶-抗中性粒细胞胞质抗体(ANCA)阳性率为91. 7%(55/60),抗蛋白酶3-ANCA阳性率为11. 7%(7/60)。影像学表现为网格影者40例,磨玻璃影者35例,条索、斑片影者30例,胸膜增厚、胸腔积液各11例,结节影8例,典型普通型间质性肺炎3例。25例患者行肺功能检查,弥散功能障碍24例,限制性通气功能障碍7例,肺动脉高压10例(19. 2%),平均肺动脉收缩压为(50±10) mm Hg(1 mm Hg=0. 133 k Pa)。48例接受治疗,34例患者应用糖皮质激素联合环磷酰胺治疗,14例患者单用糖皮质激素治疗,其中17例接受甲泼尼龙冲击治疗。除3例患者合并肺部感染致呼吸衰竭、感染性休克死亡外,其余患者均好转出院。结论 MPA肺部受累常见,肺部症状可以为首发表现,临床表现无特异性,磨玻璃影及肺间质改变为主要影像学异常,行ANCA检测及组织病理学检查有助于早期诊断、早期治疗。展开更多
文摘Inflammatory bowel disease (IBD) has been associated with either clinical or subclinical airway and parenchymal lung involvement and interstitial lung complications. Several studies have reported that atopy has a high prevalence in IBD patients. Overlapping allergic disorders seem to be present in both the respiratory and gastrointestinal systems. The purpose of this review is to update clinicians on recent available literature and to discuss the need for a highly suspicious approach by clinicians.
文摘Primary biliary cirrhosis (PBC) is a chronic progressive cholestatic liver disease caused by diffuse inflammation,destruction and fibrosis of the intrahepatic bile ducts,ultimately leading to cirrhosis,portal hypertension and liver failure.The pathogenesis of PBC is incompletely understood,but current data suggest roles for genetic susceptibility and environmental factors.PBC is often thought of as an organ-specific autoimmune disease,which mainly targets the liver;however,lung tissue is also a site for autoimmune involvement of PBC.The pulmonary manifestations of PBC include abnormalities in gas transfer and pulmonary function,subclinical alveolitis,interstitial lung disease,granulomatous lung disease,airway disease,pulmonary hypertension,pulmonary hemorrhage and pleural effusion.
文摘目的探讨显微镜下多血管炎(MPA)合并肺部疾病患者的临床特点。方法选取2009年6月至2018年7月首都医科大学附属北京安贞医院收治的MPA合并肺部疾病患者60例,回顾性分析患者的一般资料、临床表现、实验室检查和胸部CT、肺功能、肾脏病理、治疗及转归等临床资料。结果 60例患者中男38例、女22例,发病年龄40～88岁,平均(69±11)岁,30例以肺部症状为首发表现,临床表现为咳嗽、咳痰42例,咯血13例,呼吸困难24例。抗髓过氧化物酶-抗中性粒细胞胞质抗体(ANCA)阳性率为91. 7%(55/60),抗蛋白酶3-ANCA阳性率为11. 7%(7/60)。影像学表现为网格影者40例,磨玻璃影者35例,条索、斑片影者30例,胸膜增厚、胸腔积液各11例,结节影8例,典型普通型间质性肺炎3例。25例患者行肺功能检查,弥散功能障碍24例,限制性通气功能障碍7例,肺动脉高压10例(19. 2%),平均肺动脉收缩压为(50±10) mm Hg(1 mm Hg=0. 133 k Pa)。48例接受治疗,34例患者应用糖皮质激素联合环磷酰胺治疗,14例患者单用糖皮质激素治疗,其中17例接受甲泼尼龙冲击治疗。除3例患者合并肺部感染致呼吸衰竭、感染性休克死亡外,其余患者均好转出院。结论 MPA肺部受累常见,肺部症状可以为首发表现,临床表现无特异性,磨玻璃影及肺间质改变为主要影像学异常,行ANCA检测及组织病理学检查有助于早期诊断、早期治疗。
