NIH Library of Medicine PubMed Central

Journal List  Tuberc Respir Dis (Seoul)  v.85(2); 2022 Apr  PMC8987660

While chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) exhibit distinct clinical characteristics, they can coexist in a patient due to shared risk factors like smoking, male gender, and advanced age. Combined pulmonary fibrosis and emphysema (CPFE) is diagnosed in individuals with both emphysema in upper lung fields and diffuse ILD, leading to significant clinical deterioration. CPFE patients face higher mortality rates compared to those with COPD alone, but the evidence is inconclusive when compared to patients with idiopathic pulmonary fibrosis (IPF). Poor prognostic factors for CPFE include exacerbation, lung cancer, and pulmonary hypertension. The presence of interstitial lung abnormalities, considered an early or mild form of ILD, is noteworthy in COPD patients and is linked to an unfavorable prognosis. Pathophysiological theories for CPFE have been proposed, with biomarker analyses suggesting a closer association with IPF development rather than COPD or emphysema. Smoking cessation, routine lung function tests, and pulmonary rehabilitation are recommended for CPFE patients. While various pharmacologic agents and surgical approaches may be beneficial, additional studies are necessary.

儘管慢性阻塞性肺病(COPD)和間質性肺病(ILD)具有明顯的臨床特徵,但這兩種疾病可能在患者中同時存在,因為它們共享相似的風險因素,如吸煙、男性性別和老年。患有上肺釋放性肺氣腫和弥漫性ILD的患者被診斷為合併性肺纖維化和肺氣腫(CPFE),這導致顯著的臨床惡化。與僅患有COPD的患者相比,CPFE患者的死亡率較高,但與患有特發性纖維化性肺炎(IPF)的患者相比,結果仍然不一致。 CPFE的不良預後因素包括惡化、肺癌和肺動脈高壓。間質性肺部異常的存在(這可能是ILD的早期或輕度形式)在COPD患者中尤為引人注目,並與不良預後有關。有關CPFE的病理生理學的各種理論已被提出。生物標記分析暗示,這種病理生理可能與IPF的發展更為密切,而不是COPD或肺氣腫。建議CPFE患者戒煙,接受定期肺功能測試,並進行肺康復治療可能是有益的。雖然各種藥物和手術方法對CPFE患者可能是有益的,但還需要進一步的研究。

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