Pulmonary Fibrosis
Introduction
Introduction to pulmonary fibrosis Pulmonary fibrosis, that is, the interstitial tissue of the lung is composed of collagen, elastin and protein saccharides. When the fibroblast is chemically or physically damaged, collagen is secreted to repair the interstitial tissue of the lung, thereby causing lung fibers. The result of human body repair after the lungs are injured. Pulmonary fibrosis occurs mostly in the 40-50 age group, and men are more common in women. basic knowledge The proportion of sickness: 0.01% Susceptible people: more than 40-50 years old, males mostly in women Mode of infection: non-infectious Complications: pulmonary heart disease pulmonary hypertension
Cause
Cause of pulmonary fibrosis
Environmental factors (25%):
It is one of the important factors leading to pulmonary fibrosis disease. The current environmental pollution is serious, especially in the first-tier cities, it is even smog, which makes people's respiratory tract adhere to thick harmful substances, and finally stays in the lungs. Over time, the lungs More and more unfavorable substances will eventually form a lung disease. Pulmonary fibrosis is more common.
Smoking (20%):
According to clinical evidence, smokers are at high risk of pulmonary fibrosis, and the risk of pulmonary fibrosis in smokers is several times that of ordinary people, so we must be careful and keep away from cigarettes and secondhand smoke.
Physical factors (25%):
Asbestos, mineral dust, drugs, radiation damage, inhalation of harmful gases, etc. (in the case of environmental pollution, masks should be worn); exposure to exogenous allergic alveolitis caused by pigeon dung, animal skin, moldy hay, etc. Causes pulmonary fibrosis.
Other (15%):
Occupational, genetic, environmental, physical and chemical factors can also cause pulmonary fibrosis.
Prevention
Pulmonary fibrosis prevention
1, to avoid infection: infection will increase the symptoms and conditions of idiopathic pulmonary fibrosis, easy to ignore the small changes in breathing and aggravated cough, timely report the new symptoms to the doctor, to take treatment as soon as possible.
2. Learning and practicing relaxation: Learning to relax helps to control the fear caused by shortness of breath; excessive oxygen is consumed due to muscle tension, and physical and mental relaxation can be avoided.
3. Quit smoking: The important thing is to quit smoking. The best way to stop further damage to the lungs is to stop the stimulation. Those who have difficulty quitting smoking should seek help from their doctors.
4. Scientific attitude: Maintain a positive and peaceful attitude to face the disease. It is a wise choice to actively participate in the whole process of disease treatment.
5, maintain proper weight and good nutrition: overweight increase the burden of cardiopulmonary oxygen supply to the whole body, but also lead to shortness of breath, overweight also increase the pressure of the diaphragm and make breathing insufficient.
6, regular follow-up: timely detection of adverse reactions and changes in the condition of the drug, adjust the treatment plan.
7, regular exercise, maintain the body shape: through regular training, make the muscles become more powerful, more able to fight fatigue.
Complication
Pulmonary fibrosis complications Complications pulmonary heart disease pulmonary hypertension
1. Pulmonary infection, respiratory failure: Pulmonary fibrosis patients have decreased lung function due to weakened lung function, and most of the routine treatment of Western medicine use glucocorticoids and immunosuppressive agents to increase the incidence of lung infection. rate. When lung infection is not well controlled, respiratory failure can be induced.
2, pulmonary heart disease, heart failure: chronic hypoxia, pulmonary hypertension in patients with pulmonary fibrosis, often combined with right ventricular hypertrophy and pulmonary heart disease. Left heart failure is also common and is associated with ischemic heart disease.
3, pulmonary hypertension: pulmonary fibrosis patients with chronic hypoxia and carbon dioxide retention caused by extensive narrowing of pulmonary arterioles, increased pulmonary circulation resistance, leading to pulmonary hypertension. Pulmonary hypertension is one of the important factors affecting pulmonary fibrosis. Therefore, early detection of the disease and timely intervention, has an important impact on the patient's prognosis improvement and quality of life.
4, the impact on the respiratory system: When the arterial oxygen partial pressure drops below 60mmHg, hypoxemia stimulates the peripheral receptors, the ventilation increases, reaching a peak when the oxygen partial pressure is 30~40mmHg. The response of the respiratory center to hypoxia is much lower than that of carbon dioxide, which is due to the poor sensitivity of chemoreceptors to hypoxemia. Ventilation increased during chronic hypoxia. When the arterial oxygen partial pressure is significantly reduced, it has an inhibitory effect on the respiratory center. Severe hypoxia can cause irregular breathing and tidal breathing. The more severe the hypoxia, the sooner the pulmonary heart disease occurs. Long-term hypoxia can reduce the body's immunity and prone to acute respiratory infections.
5, the impact on the circulatory system: Hypoxemia stimulates the sympathetic nerve through chemoreceptors. In the early stage of acute hypoxia, due to the direct reaction of blood vessels and the influence of nerve reflex, the heart rate is increased, blood pressure is increased, and cardiac output is increased. An increase in cardiac output occurs immediately after the increase in catecholamines by an immediate reaction of chemoreceptors. With the aggravation of hypoxemia, arrhythmia will occur, and then blood pressure will drop, heart rate will slow down, and cardiac output will decrease. In chronic hypoxia, cardiac output does not change significantly with the surrounding environment, but pulmonary vascular resistance increases, resulting in aggravation of right heart load and chronic pulmonary heart disease in the long term.
Symptom
Pulmonary fibrosis symptoms Common symptoms Cyanosis dry cough and phlegm respiratory failure hypoxemia
The onset is concealed and progressively worsened. It is characterized by progressive shortness of breath, dry cough with less sputum or a small amount of white sticky sputum, and late stage hypoxemia-based respiratory failure. Physical examination showed that the thoracic respiratory movement was weakened, and the lungs could smell the fine wet rales or snoring. There are varying degrees of purpura and clubbing. Signs of right heart failure can occur in the advanced stage.
Examine
Pulmonary fibrosis examination
Hematological examination: ESR increased, immunoglobulin increased, no differential significance. However, the examination of various immunological indicators of collagen vascular disease is conducive to its diagnosis and differential diagnosis.
Chest X-ray film: Early IPF patients can show the blurring of the double lung field, such as the increased density of ground glass, suggesting the pathological basis of alveolar infiltrative lesions, and the X-ray features of alveolitis. As the disease progresses, a linear strip-like texture appears in the lung field, which is intricately like a fine mesh, called a mesh shadow. In the late stage, thick lines and coarse netting appear. When the alveolar occlusion is completed, the bronchioles are compensated and expanded into a saclike shape. When surrounded by a large amount of fibrous connective tissue, the honeycomb lung appears on the chest radiograph. Most of them have no mediastinum, lymph nodes in the hilar area, and the pleura is not invaded, but pneumothorax often occurs due to rupture of the lung.
Pulmonary function test: General routine ventilation function can be found to be related to restrictive ventilation dysfunction, and some airway obstruction is helpful in identifying airway obstructive diseases. IPF lung function tests are characterized by restrictive ventilatory disorders.
Diagnosis
Diagnosis and diagnosis of pulmonary fibrosis
1. Progressive urgency, cough, lung wet rales or sputum pronunciation.
2. X-ray examination: early glassy, typical changes in diffuse line, nodular, cloud-like, reticular shadow, lung volume reduction.
3. Laboratory examination: It can be seen that ESR and LDH increase, generally no special significance.
4. Pulmonary function test: visible lung volume reduction, diffuse function reduction and hypoxemia.
5. Lung tissue biopsy provides a pathological basis. This disease should be distinguished from asthmatic bronchitis.
