1, interstitial lung disease including which diseases
Interstitial lung disease is a group of diseases, including more than 150 diseases, is a collective term for lesions that manifest on chest imaging as multiple shadows in both lungs, also known as diffuse substantial lung disease, mainly including.
(1) known etiologies
1) Connective tissue disease-associated interstitial lung disease, also known as autoimmune disease-associated interstitial lung disease.
2)Occupation-related interstitial lung disease.
3)Drug-related interstitial lung disease.
4)Environment-related interstitial lung disease.
(2)Unknown etiology
1)Idiopathic interstitial pneumonia.
2)Granulomatous lung disease.
3)Specific types of interstitial lung disease.
2. Which connective tissue diseases are prone to interstitial lung lesions
Rheumatoid arthritis, systemic sclerosis, dry syndrome, dermatomyositis/polymyositis and other connective tissue diseases are prone to interstitial lung lesions.
3.Which drugs are likely to cause interstitial lung disease
Amiodarone, propylthiouracil, bleomycin, cyclophosphamide, etc.
4.Idiopathic interstitial pneumonia includes which
Idiopathic interstitial pneumonia refers to a group of interstitial lung diseases of unknown cause, which are mainly diagnosed by the pathological findings of lung biopsy. It includes the following 7 types: ① idiopathic pulmonary fibrosis; ② nonspecific interstitial pneumonia; ③ cryptogenic mechanized pneumonia; ④ lymphocytic interstitial pneumonia; ⑤ respiratory fine bronchitis combined with interstitial pneumonia; ⑥ desquamative pneumonia; ⑦ acute interstitial pneumonia.
5.Is interstitial lung disease the same as pulmonary fibrosis?
Interstitial lung disease and pulmonary fibrosis are two different disease spectrums. Pulmonary fibrosis is a part of interstitial lung disease, which refers to the deposition of a large number of collagen fibers in the lung and the manifestation of honeycomb lung visible on chest CT.
6.What are the common drugs used in the treatment of interstitial lung disease
The main drugs used in the treatment of interstitial lung disease include.
(1) Glucocorticoids, or hormones as they are called in the old days.
(2) immunosuppressive or cytotoxic drugs.
(3) Targeted therapy drugs.
7.What are the commonly used glucocorticoids
(1) Long-acting glucocorticoids: dexamethasone (oral and intravenous preparations).
(2) Medium-acting glucocorticoids: prednisone (also known as prednisone, oral preparation), prednisolone (also known as prednisolone, oral preparation), methylprednisolone (methylprednisolone, oral and intravenous preparation).
(3) Short-acting glucocorticoids: hydrocortisone (oral and intravenous preparations), cortisone.
The glucocorticoids commonly used for the treatment of interstitial lung disease are prednisone, prednisolone, methylprednisolone, etc.
8.Common side effects of glucocorticosteroids
Side effects of glucocorticosteroids generally occur when used for a long time and in large doses.
(1) Endocrine and metabolic aspects: hyperglycemia or even steroid-related diabetes, hyperlipidemia, loss of libido, menstrual disorders, etc.
(2) Cardiovascular system: Causes hypertension, promotes atherosclerosis, and causes heartburn and other discomforts.
(3) Skeletal system: cause or promote osteoporosis, which can cause femoral head necrosis in severe cases.
(4) Digestive system: abdominal distension, acid reflux, and in severe cases, gastrointestinal bleeding (especially when used in high doses).
(5) Central nervous system: agitation, insomnia, delirium and agitation can occur in high doses.
(6) Immune system: suppression of immune (cellular and humoral immunity) function, thus making the patient susceptible to bacterial, fungal, and viral infections.
(7) Skin: thinning of the skin and purple skin lines.
(8) Eyes: cataracts, glaucoma.
(9) Others: Affect the growth and development of adolescents, affect the healing of wounds, etc.
9.What are the precautions in glucocorticoid treatment of interstitial lung disease
(1) Glucocorticoid therapy for interstitial lung disease requires a long-term process, generally at least six months. It is necessary to follow up regularly at the clinic of the treating doctor to guide the reduction and discontinuation plan of glucocorticosteroids, and not to stop abruptly.
(2) Pay attention to the monitoring of blood glucose, especially the blood glucose level 2 hours after Chinese meal and 2 hours after dinner. To facilitate the monitoring of blood glucose level, if the economic situation permits, it is recommended to buy a home blood glucose meter and learn to monitor blood glucose level by yourself.
(3) Pay attention to the monitoring of blood pressure level, especially for patients with hypertension when the dose of glucocorticoids is relatively high.
(4) Monitor blood lipid levels, which can be reviewed regularly (triglyceride and cholesterol levels, which can be done once every 2-3 months).
(5) Appropriate calcium supplements, sun exposure (if there is no photosensitivity) and regular rechecking of bone density to reduce or detect osteoporosis early.
(6) In order to minimize the side effects of glucocorticoids, it is recommended to take tablets at 7-8 am.
(7) Try to go to places with noisy people and high population density to avoid cross infection.
(8) Avoid getting cold and flu as much as possible, and if you accidentally catch a cold, seek medical attention as soon as possible.
10.What are the immunosuppressants commonly used in the treatment of interstitial lung disease?
Commonly used are cyclophosphamide (oral and intravenous preparations), azathioprine (oral preparations mainly), methotrexate (oral preparations). Cyclosporine A, morte-macrolide, leflunomide, etc. are not commonly used.
11.What are the common clinical manifestations of interstitial lung disease
Common clinical symptoms include dry cough (or irritating dry cough), shortness of breath after activity, and sputum production is usually not large. Some patients may also have hemoptysis, fever and other symptoms. The common signs are pestle finger, cyanosis, and popping sound in both lower lungs.
12. What tests or labs are commonly used to initially screen for interstitial lung disease?
High-quality high-resolution CT of the chest and pulmonary function tests (including diffusion function, volume and ventilation) play an important role in the initial screening for interstitial lung disease. If no abnormality is seen on either of these (especially chest high-resolution CT), interstitial lung disease can be largely excluded.