特发性肺(间质)纤维化诊断和治疗指南(草案)

:,,,110001()()(interstitiallungdisease,ILD),(idiopathicpulmonaryfibrosis,IPF),IPFCT(HRCT)(BALF),,,():IPF(UIP),UIP(IIP),/(DIP/RBILD)(NSIP)(AIP)()11,21,21,,31,,,4150%(),velcro51,()X()11,315mm()21:,,31,X()HRCT11HRCT2,IPF21,31,,,()()11,(TLC)(FRC)(RV)1(FEV1)/(FVC)21(DLCO),,DLCO31/,(PaO2)(PaCO2),2P(A2a)O2()BALF11BALFILD()IPF21IPFBALF(PMN),5%,()11IPF21,(LDH)31,(ANA)(RF)()11/UIP21,,31,,,41,,51ILDIIP89420027417ChinJInternMed,July2002,Vol41,No.7©1994-2008ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.(/)()11UIP21,31,()41XHRCT()()IPF,,3/4,IPF11:(1)ILD,;(2),[(VC),FEV1/FVC]()(/P(A2a)O2DLCO);(3)HRCT,,;(4)(TBLB)BALF21:(1)50;(2);(3)3;(4)velcroIPFILD,IIPIPFIIP60%,NSIP,DIP/RBILDAIPUIPIIP,()DIP/RBILD11DIP:,,,(),,IPF/UIP,UIPDIPRBILD:DIP()2/3HRCT2,21DIP(AM),,,,,UIPAM,,RBILD31()AIP11AIP,,,21(DAD)31AIP,,,12()NSIP11,,,21,CT31,,,UIPDIPAIP,NSIP41,IPF(),/,:,():11:,015mg/kg(,)4;0125mg/kg,8;01125mg/kg0125mg/kg121:2mg/kg2550mg,714d25mg,150mg/d31:23mg/kg2550mg/d,714d25mg,150mg/d()11:(1)3,,,6(2)6,,;,(3)12,;,(4)18,21:(1):,XHRCTTLCVCDLCOPaO2:TLCVC99420027417ChinJInternMed,July2002,Vol41,No.7©1994-2008ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.(SaO2)4%;PaO24mmHg(22)(2):,XHRCT,:TLCVC10%200ml;DLCO15%3mlmin-1mmHg-1;SaO24%,P(A2a)O24mmHg(22)(),:11N2(NAC)(SOD),NAC(118g/d)212E2,31,PMN(0125g/d)41:,016mg/d,(:2002204208)(:):100088:,Email:yuezhuliang@1631net,141999918,,T3:1128nmol/L,T4:95146nmol/L,:,:125mg/d20d,,,,,0175mg/d,:01430189mmol/L2,52d,015mg/d,:01550159mmol/L9,T3:0191nmol/L,T4:50131nmol/L,,(TSH):1018mU/L:50g/d2,T3:1101nmol/L,T4:51160nmol/L,TSH:1012mU/L,50g/d3:T3:1125nmol/L,T4:87121nmol/L,TSH:318mU/L,,,0175mg/d,:01660188mmol/L,T3:1103nmol/L,T4:55147nmol/L,TSH:1016mU/L,,1,T3:1132nmol/L,T4:107107nmol/L,TSH:217mU/L,,,T3T42060,,[1]T3T4TSH,,6,[2],,,T3T4TSH,,,1,,,.T3T4TSH.,1998,10:2652266.2,.().10.:,1998.1032.(:2002201210)(:)00520027417ChinJInternMed,July2002,Vol41,No.7©1994-2008ChinaAcademicJournalElectronicPublishingHouse.Allrightsreserved.