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首页> 外文期刊>Respirology : >Transbronchial biopsy is clinically useful in classifying patients with interstitial pneumonia associated with polymyositis and dermatomyositis.
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Transbronchial biopsy is clinically useful in classifying patients with interstitial pneumonia associated with polymyositis and dermatomyositis.

机译：经支气管活检对将多发性肌炎和皮肌炎相关的间质性肺炎患者进行分类具有临床意义。

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BACKGROUND AND OBJECTIVE: The histological type of intraluminal fibrosis is an important prognostic factor for interstitial pneumonia. We therefore examined whether transbronchial lung biopsy (TBLB) specimens are useful for predicting the clinical course and prognosis of patients with interstitial pneumonia associated with polymyositis and dermatomyositis (PM/DM), with particular attention to the different types of intraluminal fibrosis. METHODS: Twenty-five cases of interstitial pneumonia associated with PM/DM were classified according to the pattern of intraluminal fibrosis as assessed by TBLB, and the clinical course and response to treatment were compared. Interstitial fibrosis was evaluated by sequential thin-section CT scans. RESULTS: In 19 of 25 (76%) cases, there was sufficient intraluminal fibrosis to perform an evaluation. Intraluminal fibrosis was classified as bud (polyp) type or mural incorporation type (either alone or mixed with bud type). The bud type was seen in five cases and these improved following treatment with corticosteroids only. The mural incorporation type was seen in 14 cases. In 11 of these 14 cases, progressive long-term fibrosis developed and four cases were fatal, in spite of corticosteroid and immunosuppressive therapy. The response to drugs (P < 0.01) and survival (P < 0.05) were significantly greater in patients with bud-type than mural incorporation-type intraluminal fibrosis. CONCLUSIONS: Classification of the pattern of intraluminal fibrosis as assessed by TBLB is useful for predicting the response to treatment, clinical course and prognosis of interstitial pneumonia associated with PM/DM.
机译：背景与目的：腔内纤维化的组织学类型是间质性肺炎的重要预后因素。因此，我们检查了经支气管肺活检（TBLB）标本是否可用于预测伴有多发性肌炎和皮肌炎（PM / DM）的间质性肺炎的临床病程和预后，尤其要注意腔内纤维化的不同类型。方法：根据TBLB评估管腔内纤维化的类型，对25例PM / DM伴有间质性肺炎的患者进行分类，并比较其临床病程和对治疗的反应。间质纤维化是通过连续的薄层CT扫描评估的。结果：25例中的19例（76％）有足够的管腔内纤维化以进行评估。管腔内纤维化分为芽（息肉）型或壁合并型（单独或与芽型混合）。五例出现芽型，仅用皮质类固醇激素治疗后病情好转。壁画合并类型见14例。尽管使用了皮质类固醇和免疫抑制疗法，但在这14例病例中的11例中，发生了进行性长期纤维化，其中4例是致命的。芽型患者对药物的反应（P <0.01）和存活率（P <0.05）明显大于壁合并型管腔内纤维化。结论：TBLB评估管腔内纤维化的类型有助于预测对PM / DM相关性间质性肺炎的治疗反应，临床病程和预后。

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