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Interstitial Lung Diseases in Developing Countries

机译:发展中国家的间质性肺疾病

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摘要

More than 100 different conditions are grouped under the term interstitial lung disease (ILD). A diagnosis of an ILD primarily relies on a combination of clinical, radiological, and pathological criteria, which should be evaluated by a multidisciplinary team of specialists. Multiple factors, such as environmental and occupational exposures, infections, drugs, radiation, and genetic predisposition have been implicated in the pathogenesis of these conditions. Asbestosis and other pneumoconiosis, hypersensitivity pneumonitis (HP), chronic beryllium disease, and smoking-related ILD are specifically linked to inhalational exposure of environmental agents. The recent Global Burden of Disease Study reported that ILD rank 40th in relation to global years of life lost in 2013, which represents an increase of 86% compared to 1990. Idiopathic pulmonary fibrosis (IPF) is the prototype of fibrotic ILD. A recent study from the United States reported that the incidence and prevalence of IPF are 14.6 per 100,000 person-years and 58.7 per 100,000 persons, respectively. These data suggests that, in large populated areas such as Brazil, Russia, India, and China (the BRIC region), there may be approximately 2 million people living with IPF. However, studies from South America found much lower rates (0.4–1.2 cases per 100,000 per year). Limited access to high-resolution computed tomography and spirometry or to multidisciplinary teams for accurate diagnosis and optimal treatment are common challenges to the management of ILD in developing countries.
机译:间质性肺病(ILD)分为100多种不同的疾病。对ILD的诊断主要取决于临床,放射学和病理学标准的综合,应由多学科的专家小组对其进行评估。这些疾病的发病机理涉及多种因素,例如环境和职业接触,感染,药物,放射线和遗传易感性。石棉沉着症和其他尘肺,超敏性肺炎(HP),慢性铍病以及与吸烟有关的ILD与环境因素的吸入有关。最近的《全球疾病负担研究》报道,相对于1990年的全球生命损失,ILD排名第40位,与1990年相比增长了86%。特发性肺纤维化(IPF)是纤维化ILD的原型。美国最近的一项研究报告说,IPF的发病率和患病率分别为每100,000人年14.6和每100,000人年58.7。这些数据表明,在巴西,俄罗斯,印度和中国(金砖四国)等人口稠密的地区,大约有200万人患有IPF。但是,来自南美的研究发现发病率要低得多(每年每10万例中有0.4-1.2例)。高分辨率计算机断层扫描和肺活量测定法或多学科团队进行准确诊断和最佳治疗的机会有限,是发展中国家对ILD管理的普遍挑战。

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