切换至 "中华医学电子期刊资源库"

中华实验和临床感染病杂志(电子版) ›› 2023, Vol. 17 ›› Issue (05) : 294 -298. doi: 10.3877/cma.j.issn.1674-1358.2023.05.002

综述

新型冠状病毒感染后肺纤维化病变诊治进展
李安琪, 徐祎琳, 向天新()   
  1. 330000 南昌市,南昌大学第一附属医院·中日友好医院江西医院
    330000 南昌市,南昌大学第一附属医院·中日友好医院江西医院;330000 南昌市,江西省重大公共卫生事件医学中心
  • 收稿日期:2023-05-08 出版日期:2023-10-15
  • 通信作者: 向天新
  • 基金资助:
    南昌大学第一附属医院临床培育项目(No. YFYLCYJPY202001)

Progress on diagnosis and treatment of post corona virus disease 2019 pulmonary fibrosis

Anqi Li, Yilin Xu, Tianxin Xiang()   

  1. The First Affiliated Hospital, Jiangxi Medcial College, Nanchang University·China-Japan Friendship Jiangxi Hospital, Nanchang 330000, China
    The First Affiliated Hospital, Jiangxi Medcial College, Nanchang University·China-Japan Friendship Jiangxi Hospital, Nanchang 330000, China; Jiangxi Medical Center for Critical Public Health Events, Nanchang 330000, China
  • Received:2023-05-08 Published:2023-10-15
  • Corresponding author: Tianxin Xiang
引用本文:

李安琪, 徐祎琳, 向天新. 新型冠状病毒感染后肺纤维化病变诊治进展[J/OL]. 中华实验和临床感染病杂志(电子版), 2023, 17(05): 294-298.

Anqi Li, Yilin Xu, Tianxin Xiang. Progress on diagnosis and treatment of post corona virus disease 2019 pulmonary fibrosis[J/OL]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2023, 17(05): 294-298.

新型冠状病毒(SARS-CoV-2)感染引起了全球出现大量急性新型冠状病毒肺炎(COVID-19)患者,随着病程演变,部分患者在急性期过后出现肺纤维化问题逐渐突显。目前学者们称之为新型冠状病毒感染后肺纤维化(PCPF)。由于SARS-CoV-2不断突变及全球医疗水平大相径庭,PCPF发生率及诊治亦存在差异。肺纤维化程度显著影响患者临床表现,患者症状迁延,需要大量医疗资源及长期的专业照护。目前PCPF诊断依靠临床结合CT及肺功能检查,治疗依靠既往其他肺纤维化疾病的治疗经验,缺乏统一、规范的处置方案。尽管许多学者为此开展研究,但仍没有十分有效的治疗方法。本文就PCPF发病及其机制进行概述,重点回顾相关诊断及治疗研究进展。

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a large number of patients with corona virus disease 2019 (COVID-19) in the world, with the evolution of the disease, the problem of pulmonary fibrosis in some patients after the acute stage has become increasingly prominent. Currently, scholars call it post COVID-19 pulmonary fibrosis (PCPF). Due to the continuous mutation of the virus and different medical levels in different parts of the world, the incidence, diagnosis and treatment of PCPF vary slightly among different studies. The degree of fibrosis significantly affects the clinical manifestations of patients, prolonged symptoms of patients, the need for a large number of medical resources and long-term professional care. At present, the diagnosis of PCPF depends on clinical combination with CT and pulmonary function test (PFT), and the treatment depends on previous treatment experience of other pulmonary fibrosis diseases, and there is a lack of unified and standardized treatment plan. Although many scholars have carried out research for this, there is still no very effective treatment. During this review the pathogenesis and mechanism of PCPF are summarized, and the research progress of related diagnosis and treatment is reviewed.

[1]
George PM, Wells AU, Jenkins RG. Pulmonary fibrosis and COVID-19: the potential role for antifibrotic therapy[J]. Lancet Respir Med,2020,8(8):807-815.
[2]
Hama Amin BJ, Kakamad FH, Ahmed GS, et al. Post COVID-19 pulmonary fibrosis; a Meta-analysis study[J]. Ann Med Surg (Lond),2022,77:103590.
[3]
Wu X, Liu X, Zhou Y, et al. 3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study[J]. Lancet Respir Med,2021,9(7):747-754.
[4]
Torres-Castro R, Vasconcello-Castillo L, Alsina-Restoy X, et al. Respiratory function in patients post-infection by COVID-19: a systematic review and Meta-analysis[J]. Pulmonology,2021,27(4): 328-337.
[5]
Tanni SE, Fabro AT, de Albuquerque A, et al. Pulmonary fibrosis secondary to COVID-19: a narrative review[J]. Expert Rev Respir Med,2021,15(6):791-803.
[6]
Saifi MA, Bansod S, Godugu C. COVID-19 and fibrosis: Mechanisms, clinical relevance, and future perspectives[J]. Drug Discov Today, 2022,27(11):103345.
[7]
Lee JH, Koh J, Jeon YK, et al. An integrated radiologic-pathologic understanding of COVID-19 pneumonia[J]. Radiology,2023,306(2):e222600.
[8]
Kostopanagiotou K, Schuurmans MM, Inci I, et al. COVID-19-related end stage lung disease: two distinct phenotypes[J]. Ann Med,2022,54(1):588-590.
[9]
中国研究型医院学会呼吸病学专业委员会, 北京中西医结合学会呼吸病分会. 新型冠状病毒感染引起的肺间质病变诊断和治疗专家建议[J]. 中华结核和呼吸杂志,2020,43(10):827-833.
[10]
Solomon JJ, Heyman B, Ko JP, et al. CT of post-acute lung complications of COVID-19[J]. Radiology,2021,301(2):e383-e395.
[11]
Doğan S, Güldiken GS, Alpaslan B, et al. Impact of COVID-19 pneumonia on interstitial lung disease: semi-quantitative evaluation with computed tomography[J]. Eur Radiol,2023,33(7):4758-4766.
[12]
McGroder CF, Zhang D, Choudhury MA, et al. Pulmonary fibrosis 4 months after COVID-19 is associated with severity of illness and blood leucocyte telomere length[J]. Thorax,2021,76(12):1242-1245.
[13]
Liu M, Lv F, Huang Y, et al. Follow-up study of the chest CT characteristics of COVID-19 survivors seven months after recovery[J]. Front Med (Lausanne),2021,8:636298.
[14]
Ball L, Barisione E, Mastracci L, et al. Extension of collagen deposition in COVID-19 post mortem lung samples and computed tomography analysis findings[J]. Int J Mol Sci,2021, 2(14):7498.
[15]
Caruso D, Guido G, Zerunian M, et al. Post-acute sequelae of COVID-19 pneumonia: six-month chest CT follow-up[J]. Radiology,2021,301(2):e396-e405.
[16]
Li X, Shen C, Wang L, et al. Pulmonary fibrosis and its related factors in discharged patients with new corona virus pneumonia: a cohort study[J]. Respir Res,2021,22(1):203-214.
[17]
Cheng D, Calderwood C, Skyllberg E, et al. Clinical characteristics and outcomes of adult patients admitted with COVID-19 in East London: a retrospective cohort analysis[J]. BMJ Open Respir Res,2021,8(1):e000813.
[18]
Trinkmann F, Müller M, Reif A, et al. Residual symptoms and lower lung function in patients recovering from SARS-CoV-2 infection[J]. Eur Respir J,2021,57(2):2003002.
[19]
Mylvaganam RJ, Bailey JI, Sznajder JI, et al. Recovering from a pandemic: pulmonary fibrosis after SARS-CoV-2 infection[J]. Eur Respir Rev,2021,30(162):210194.
[20]
廖宝林, 施海燕, 刘艳霞, 等. 新型冠状病毒肺炎患者早期外周血淋巴细胞亚群及细胞因子特征[J/CD]. 中华实验和临床感染病杂志(电子版),2021,15(3):182-188.
[21]
Al-Kuraishy HM, Batiha GE, Faidah H, et al. Pirfenidone and post-COVID-19 pulmonary fibrosis: invoked again for realistic goals[J]. Inflammopharmacology,2022,30(6):2017-2026.
[22]
Sakızcı Uyar B, Ensarioğlu K, Kurt E B, et al. Anti-fibrotic treatment for pulmonary fibrosis induced by COVID-19: A case presentation[J]. Turk J Anaesthesiol Reanim,2022,50(3):228-231.
[23]
Zhou X, Yang D, Kong X, et al. Case report: pirfenidone in the treatment of post-COVID-19 pulmonary fibrosis[J]. Front Med (Lausanne),2022,9:925703.
[24]
Zhang F, Wei Y, He L, et al. A trial of pirfenidone in hospitalized adult patients with severe coronavirus disease 2019[J]. Chin Med J (Engl),2021,135(3):368-370.
[25]
Wollin L, Wex E, Pautsch A, et al. Mode of action of nintedanib in the treatment of idiopathic pulmonary fibrosis[J]. Eur Respir J,2015,45(5):1434-1445.
[26]
Lamb YN. Nintedanib: A review in fibrotic interstitial lung diseases[J]. Drugs,2021,81(5):575-586.
[27]
Ogata H, Nakagawa T, Sakoda S, et al. Nintedanib treatment for pulmonary fibrosis after coronavirus disease 2019[J]. Respirol Case Rep,2021,9(5):e00744.
[28]
Bussolari C, Palumbo D, Fominsky E, et al. Case report: Nintedaninb may accelerate lung recovery in critical coronavirus disease 2019[J]. Front Med (Lausanne),2021,8:766486.
[29]
牟向东, 赵景全. 北京清华长庚呼吸中心重型新冠病毒肺炎简明诊治建议(第一版)[EB/OL]. 2022-12-19.

URL    
[30]
Myall KJ, Mukherjee B, Castanheira AM, et al. Persistent post-COVID-19 interstitial lung disease. An observational study of corticosteroid treatment[J]. Ann Am Thorac Soc,2021,18(5):799-806.
[31]
Chen Q, Yang Q, Fang Y, et al. Potential benefits of precise corticosteroid therapy for critical COVID-19[J]. Respir Physiol Neurobiol,2022,297:103813.
[32]
Kostorz-Nosal S, Jastrzębski D, Chyra M, et al. A prolonged steroid therapy may be beneficial in some patients after the COVID-19 pneumonia [J]. Eur Clin Respir J,2021,8(1):1945186.
[33]
Micheletto C, Izquierdo JL, Avdeev SN, et al. N-acetylcysteine as a therapeutic approach to post-COVID-19 pulmonary fibrosis adjunctive treatment[J]. Eur Rev Med Pharmacol Sci,2022,26(13):4872-4880.
[34]
Martinez FJ, de Andrade JA, Anstrom KJ, et al. Randomized trial of acetylcysteine in idiopathic pulmonary fibrosis[J]. N Engl J Med,2014,370(22):2093-2101.
[35]
Demedts M, Behr J, Buhl R, et al. High-dose acetylcysteine in idiopathic pulmonary fibrosis[J]. N Engl J Med,2005,353(21):2229-2242.
[36]
Shi H, Yin D, Bonella F, et al. Efficacy, safety, and tolerability of combined pirfenidone and N-acetylcysteine therapy: a systematic review and meta-analysis[J]. BMC Pulm Med,2020,20(1):128-136.
[37]
Sakamoto S, Kataoka K, Kondoh Y, et al. Pirfenidone plus inhaled N-acetylcysteine for idiopathic pulmonary fibrosis: a randomised trial[J]. Eur Respir J,2021,57(1):2000348.
[38]
Heister PM, Poston RN. Pharmacological hypothesis: TPC2 antagonist tetrandrine as a potential therapeutic agent for COVID-19[J]. Pharmacol Res Perspect,2020,8(5):e00653.
[39]
Wu WH, Feng YH, Min CY, et al. Clinical efficacy of tetrandrine in artificial stone-associated silicosis: A retrospective cohort study[J]. Front Med (Lausanne),2023,10:1107967.
[40]
Chen S, Liu Y, Ge J, et al. Tetrandrine treatment may improve clinical outcome in patients with COVID-19[J]. Medicina (Kaunas),2022,58(9):1194.
[41]
Alva R, Mirza M, Baiton A, et al. Oxygen toxicity: cellular mechanisms in normobaric hyperoxia [J]. Cell Biol Toxicol,2023,39(1):111-143.
[42]
Hardinge M, Annandale J, Bourne S, et al. British Thoracic Society guidelines for home oxygen use in adults[J]. Thorax,2015,70(Suppl 1):i1-i43.
[43]
Jacobs SS, Krishnan JA, Lederer DJ, et al. Home oxygen therapy for adults with chronic lung disease. an official american thoracic society clinical practice guideline[J]. Am J Respir Crit Care Med,2020,202(10):e121-e141.
[44]
Meng F, Xu R, Wang S, et al. Human umbilical cord-derived mesenchymal stem cell therapy in patients with COVID-19: a phase 1 clinical trial[J]. Signal Transduct Target Ther,2020,5(1):172-178.
[45]
Shi L, Huang H, Lu X, et al. Effect of human umbilical cord-derived mesenchymal stem cells on lung damage in severe COVID-19 patients: a randomized, double-blind, placebo-controlled phase 2 trial[J]. Signal Transduct Target Ther,2021,6(1):58-66.
[46]
Bharat A, Machuca TN, Querrey M, et al. Early outcomes after lung transplantation for severe COVID-19: a series of the first consecutive cases from four countries[J]. Lancet Respir Med,2021,9(5):487-497.
[47]
Kurihara C, Manerikar A, Querrey M, et al. Clinical characteristics and outcomes of patients with COVID-19-associated acute respiratory distress syndrome who underwent lung transplant[J]. JAMA,2022,327(7):652-661.
[1] 中华医学会器官移植学分会肺移植学组, 国家肺移植质控中心. 新型冠状病毒感染肺移植受者选择中国专家建议[J/OL]. 中华移植杂志(电子版), 2023, 17(01): 13-16.
[2] 王亚岚, 倪婧, 余世庆, 陶银花, 张荣. 尼达尼布抗纤维化治疗特发性肺纤维化的耐受性和疗效预测因素分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(05): 750-755.
[3] 周璇, 谢莉, 邹娟. 尼达尼布对特发性肺纤维化肺功能、肺纤维化程度及PDGF、PGE2、TGF-β1的影响[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(03): 368-372.
[4] 邱凌霄, 王创业, 卿斌, 刘锦程, 张鑫烨, 武文娟, 邢德冰, 郭亮, 徐智, 王斌. 基于转录组学筛选特发性肺纤维化的枢纽基因和信号通路[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(02): 212-217.
[5] 吴沛玲, 娄月妍, 张洪艳, 陈东方, 刘雪青, 赵丽芳, 薛姗, 蒋捍东. 线粒体相关基因在特发性肺纤维化中的分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(02): 178-184.
[6] 拉周措毛, 山春玲, 李国蓉, 华毛. 青海西宁地区IPF-LC的病理类型及临床特征分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(01): 25-29.
[7] 范会业, 毛杨, 王文静, 李德峰. 大蒜素改善博莱霉素诱导小鼠肺纤维化的作用分析[J/OL]. 中华肺部疾病杂志(电子版), 2024, 17(01): 9-13.
[8] 张晶晶, 刘锦, 张玉华. 高流量无创呼吸湿化治疗仪对肺纤维化并发感染及氧分压的影响[J/OL]. 中华肺部疾病杂志(电子版), 2023, 16(06): 883-885.
[9] 谷先勇, 徐娟. 特发性肺纤维化合并T2DM炎症水平与预后相关性分析[J/OL]. 中华肺部疾病杂志(电子版), 2023, 16(05): 721-723.
[10] 许娟, 张党锋. 尼达尼布对肺纤维化小鼠肺功能及内质网应激反应的影响[J/OL]. 中华肺部疾病杂志(电子版), 2023, 16(05): 673-675.
[11] 陈向军, 顾兴, 王在强, 王光辉, 王莉, 方芳, 金发光, 王瑞璇. 颗粒酶B激活TGF-β1/Smad3通路促进博来霉素导致的肺纤维化[J/OL]. 中华肺部疾病杂志(电子版), 2023, 16(05): 630-634.
[12] 李青原, 冯同, 邱雪琴, 李万成. 迷迭香提取物防治肺纤维化研究进展[J/OL]. 中华肺部疾病杂志(电子版), 2022, 15(06): 908-911.
[13] 田学, 谢晖, 王瑞兰. 急性呼吸窘迫综合征相关肺纤维化的研究进展[J/OL]. 中华重症医学电子杂志, 2024, 10(03): 258-264.
[14] 王吉, 张颖, 顾雪, 杨朋磊, 陈齐红. 间充质干细胞微泡对ARDS肺纤维化影响的实验研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(01): 72-78.
[15] 吕昆明, 王沙沙, 万军, 令狐恩强. 胃食管反流病与特发性肺纤维化关系的研究进展[J/OL]. 中华胃肠内镜电子杂志, 2023, 10(02): 121-124.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?