Diagnostic value of three IPF examinations in interstitial lung disease
The three tests of IPF refer to IPF radionuclide, IPF lung function and IPF lung biopsy, each of which has its own advantages. The combination of the three can provide accurate basis for the diagnosis of various interstitial lung diseases such as idiopathic pulmonary fibrosis from all angles, levels and multi-layers. For example, IPF radionuclide, inhaling 99mTc-DTPA aerosol can enhance the permeability of alveolar capillary membrane, measure the permeability of LEP epithelium, and shorten T 1 to T 2, which is helpful for early detection and diagnosis of interstitial lung disease.
IPF pulmonary function test can obtain the change index of typical pulmonary function in interstitial lung disease, such as limited ventilatory damage, reduced lung volume, decreased lung compliance and decreased diffusion capacity. If PaO2 decreases and PA-aO2 widens, it indicates that interstitial lung disease is already very serious, close to interstitial pulmonary fibrosis. Especially in the post-exercise test, there are some changes, such as the decrease of diffuse volume and the imaging changes of hypoxic blood syndrome, which is beneficial to the early diagnosis.
The dynamic observation of pulmonary function examination has great implications for the prediction of IPF, and can also examine the therapeutic effect of interstitial lung disease and idiopathic pulmonary fibrosis, but there is no specific abnormal pulmonary function of IPF, so it has no diagnostic value. If there is an increase in the total number of cells in bronchoalveolar lavage fluid and the increase in the proportion of neutrophils is conducive to the diagnosis of IPF, but it is still mainly used for research.
Lung biopsy can identify the histological changes of IPF in the early and middle stages, and the etiology of interstitial lung disease, many of which include many patients with definite causes, so lung biopsy is of great significance for the diagnosis and activity evaluation of interstitial lung disease. Fiberoptic bronchoscopy is the first choice for TBLB, but the specimen is small, so it is fashionable and difficult to diagnose, and thoracotomy and biopsy should be performed if necessary.
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