慢性阻塞性肺疾病合并肺间质纤维化的研究进展’

Current situation of study on chronic obstructive pulmonary diseases complicating pulmonary fibrosis

随着对慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）研究的不断深入，COPD后期肺间质纤维化（pulmonary interstitial fibrosis，PIF）的改变逐渐取代了肺气肿的固有变化的现象已经被多位学者证实，并被临床工作者接受，使以往认为COPD与PIF是两种相互独立、不能共存的疾病类型的观点发生改变。双重的病理改变更加严重地破坏了肺组织结构，造成严重缺氧和弥散功能障碍，使COPD病情恶化加速，其发病率及病死率逐年增高，已引起学术界的广泛关注，并对其进行了深入研究，但突破性进展仍有待时日。目前尚存在的瓶颈问题包括病因不清、发病机制复杂、病情多呈进行性进展、临床缺乏早期诊断手段、缺乏有效的治疗措施等，而恰恰早期诊断和恰当的治疗仍可望改善患者的生活质量和延长生存期。本文阐述了c0PD合并PIF的发病机制、诊断、治疗方面的研究现状，以深化对COPD合并PIF的认识，为临床提供预防、诊断及抗炎、抗纤维化的治疗思路。

With the further research of chronic obstructive pulmonary diseases （COPD）, in the later stage of COPD,not only the phenomena that the changes of pulmonary interstitial fibrosis （PIF） is replacing the innate changes of emophysematous architecture gradually has been confirmed by scholars and accepted by clinicians, but also the view that COPD and PIF are two independent disease types is changing. The double pathological change would further damage the lung tissue, lead to severe hypoxia and dysfunction of diffusion and aggravate the condition of COPD. With the increasing rate of morbidity and mortality, COPD with PIF has been further studied and attracted attentions of academia, but it is still a long way to make breakthrough progress. The current bottleneck problems include unclear cause and pathogenesis, the progressing worsen of conditions, the lack of methods of early diagnosis and efficient therapy and so on. And just the correct early diagnosis and proper therapy may improve the patients＇ quality of life and prolong their life span. The article reports the current study status of pathogenesis, diagnosis, management of COPD with PIF in order to deepen the cognition of this kind of disease, as well as to provide ideas about its prevention, diagnosis and the therapy of anti-inflammatory and anti-fibrosis for clinic.