目的：分析普通型间质性肺炎病理特征以及与特发性非特异性间质性肺炎诊断鉴别。方法回顾分析70例疑为IIP与双肺弥漫性病变患者临床资料，采取开胸肺活检或者是电视胸腔镜，其中20例UIP(UIP组)，15例INSIP(INSIP组)，15例采取手术切除远离肺癌原发灶周边肺组织(对照组)。结果在纤维母细胞灶、肺泡结构改建、镜下蜂窝肺、弥漫胶原沉积、肌硬化检出方面，UIP组、INSIP组明显高于对照组,差异有统计学意义(P<0.05)。结论对肺纤维化发生发展产生影响的关键因素为Th1/Th2细胞因子之间的平衡与否，这可能也是NSIP与UIP发病的差异，UIP与NSIP均无典型的临床表现，临床鉴别诊断时还应结合肺活检病理实验，确保诊断的准确性。%Objective To analyze the clinicopathological features of usual interstitial pneumonia and differential diagnosis between it and Idiopathic nonspecific interstitial pneumonia. Methods Clinical data of 70 patients with suspected IIP and double diffuse pulmonary lesionsin who had received open lung biopsy or thoracoscopy were retrospectively analyzed, 20 patients as UIP groups and 15 as INSIP group, 15 who received resection operation of peripheral lung tissue far away from primary lung cancer tissues as control group. Results In fibroblast foci, alveolar structure reconstruction, microscopically honeycombing, diffuse collagen deposi-tion, muscle stiffness detection, UIP, INSIP group is significantly higher than control group (P<0.05),Statistically significant. Con-clusion The key factors that affect the development of pulmonary fibrosis is the balance between Th1/Th2 cytokines or not, and it may also represent the difference of pathogenesis of NSIP and UIP, the two of which are of no typical clinical manifestations. Clin-ical differential diagnosis of them should also be combined with lung biopsy pathology experiments so as to ensure the accuracy.
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