老年肺间质纤维化的临床特征

目的 总结老年人肺间质纤维化的临床特征。结论 对38例老年人间质纤维化临床表现、胸部影像学、动脉血气、肺功能及经纤支镜肺活检进行分析。结果 老年人肺间质纤维经主要为干咳或进行性呼吸困难，双下肺可闻及爆裂音，并发慢性阻塞性肺疾病（COPD）及肺部感染，可有咳痰及湿性罗音；胸部影像学表现为毛玻璃样、结节状、网格状及蜂窝状阴影，以两中下肺为主；PaO2降低，合并COPD者可出现PaCO2升高；多为限制性通气功能障碍，肺弥散功能下降，合并COPD者出现混合性通气功能障碍。肺活检显示肺泡间隔增宽，间隔内纤维组织增生及胶原沉积。结论 老年人肺间质纤维化易并发于COPD等疾病，具有其自身的临床特征。

The clinical characteristics of pulmonary interstitial fibrosis in the elderly

Objective To provide theoretical basis for clinical diagnosis,treatment and prognosis of pulmonary interstitial fibrosis in the elderly. Methods Causes,clinical characteristics,radiography,high resolution CT(HRCT),arterial blood gases,lung function and lung biopsy specimens in 38 elder patients with pulmonary fibrosis were analysed. Results Clinical features included cough,progressing dyspnea and cracles in auscultation.Radiographic and HRCT findings showed ground glass appearance,nodular,reticular and honeycombing pattern.Pulmonary function test showed restrictive ventilation and diffusive dysfunction.Blood gas analysis suggested reduced PaO 2 and increased PaCO 2 accompanied with COPD.Histologic apperance of lung biopsy included alveolar interval increasement,fibrosis and collogen sediment. Conclusions The pulmonary interstitial fibrosis in the elderly had its clinical features and it was easily accompanied by COPD.