《尘肺病治疗中国专家共识(2024年版)》解读

Interpretation of Consensus of Chinese experts on pneumoconiosis treatment(2024)

《尘肺病治疗中国专家共识(2024年版)》最重要的修订是重视尘肺病抗纤维化治疗,推荐汉防己甲素和尼达尼布用于治疗矽肺、煤工尘肺,特别是快进型矽肺患者;另外,对肺移植采取了积极的态度,推荐终末期尘肺病经内科最优化的保守治疗仍然无效的患者,尽早进行肺移植。除此之外,此次修订内容还包括增加宏基因组新一代测序技术(mNGS)在尘肺合并肺部感染的应用,增加尘肺病合并非结核分枝杆菌肺病(NTM肺病)的诊治,以及增加尘肺并发呼吸衰竭治疗中经鼻高流量氧疗。本版本共识采用推荐分级的评估、制定与评价(GRADE)证据等级系统作为证据和推荐意见的评价方法。

The most important revision of the Consensus of Chinese experts on pneumoconiosis treatment(2024)is to attach importance to antifibrotic treatment,and recommend tetrandrine and nintedanib for the treatment of silicosis and coal worker's pneumoconiosis,especially in patients with rapidly progressing silicosis.The second most important revision is a positive attitude towards lung transplantation which is recommended for patients with end-stage pneumoconiosis who do not respond to medically optimized conservative treatment as early as possible.In addition,new updates also include the addition of the application of metagenomic next-generation sequencing(mNGS)in pneumoconiosis with pulmonary infection,the diagnosis and treatment of pneumoconiosis with nontuberculous mycobacteriosis(NTM),and high-flow nasal cannula oxygen therapy(HFNC)in pneumoconiosis with respiratory failure therapies.The evidence and recommendations of the current version are assessed by the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)system.