新型冠状病毒肺炎炎症后肺纤维化的现状与思考  

Postinflammatroy pulmonary fibrosis of COVID-19:the current status and perspective

作　　者：詹曦[1] 刘冰[2] 童朝晖[1] Zhan Xi;Liu Bing;Tong Zhaohui(Department of Respiratory and Critical Care Medicine,Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Department of Respiratory and Critical Care Medicine,Zhongnan Hospital,Wuhan University,Wuhan 430071,China)

机构地区：[1]首都医科大学附属北京朝阳医院呼吸与危重症医学科北京市呼吸疾病研究所,100020 [2]武汉大学中南医院呼吸与危重症医学科,430071

出　　处：《中华结核和呼吸杂志》2020年第9期728-732,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：新型冠状病毒肺炎(COVID-19)在中国的疫情已经得到控制。然而,很多患者在出院时都有炎症后肺纤维化,部分表现为普通型间质性肺炎(UIP)或非特异性间质性肺炎(NSIP);并有不同程度的活动后呼吸困难。此炎症后肺纤维化能否完全吸收,对肺功能的影响是否会持续存在,只有随访能够回答。现有治疗肺纤维化的药物是吡非尼酮和尼达尼布,尚未有应用于炎症后肺纤维化的报道。根据既往SARS和MERS的随访经验及目前COVID-19的控制现状,我们需对出院患者加强随访,以了解炎症后肺纤维化的转归,必要时开展药物临床观察。The novel coronavirus pneumonia(COVID-19)has been well controlled in China.Most of the COVID-19 patients were having postinflammatory pulmonary fibrosis(PPF)on the follow-up CT scan when discharged,and complaining about exertional dyspnea of different levels,presenting with an UIP(usual interstitial pneumonia)pattern or NSIP(non-specific interstitial pneumonia)pattern on the CT scans.Will the PPF get improved or stay stable,or progress?Such questions could only be answered by follow-up and monitoring of the pulmonary function.At the same time,we should learn from the lessons on pulmonary function loss of the SARS patients and MERS patients,some of whom had persistent impaired lung function after discharge.Pirfenidone and Nintedanib had been approved for the treatment of idiopathic pulmonary fibrosis(IPF),showing effectiveness on non-IPF pulmonary fibrosis as well.However,there are no studies about the application on PPF resulting from viral pneumonia.Given the follow-up status of SARS patients and MERS patients,and the PPF of COVID-19 patients,we should be careful about the discharged patients with a close follow-up,and further studies on PPF of COVID-19 are needed.

关 键 词：新型冠状病毒肺炎 炎症后肺纤维化 普通型间质性肺炎 非特异性间质性肺炎 

分 类 号：R563.1[医药卫生—呼吸系统] R563.9[医药卫生—内科学]