内科理论与实践 ›› 2024, Vol. 19 ›› Issue (01): 72-76.doi: 10.16138/j.1673-6087.2024.01.13

• 讲座 • 上一篇    下一篇

肺移植术后闭塞性细支气管炎诊治进展

朱海星, 周敏()   

  1. 上海交通大学医学院附属瑞金医院呼吸与危重症医学科,上海 200025
  • 收稿日期:2023-09-20 出版日期:2024-02-29 发布日期:2024-04-28
  • 通讯作者: 周敏 E-mail:doctor_zhou_99@163.com

Progress in diagnosis and treatment of obliterated bronchiolitis after lung transplantation

ZHU Haixing, ZHOU Min()   

  1. Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2023-09-20 Online:2024-02-29 Published:2024-04-28
  • Contact: ZHOU Min E-mail:doctor_zhou_99@163.com

摘要:

闭塞性细支气管炎综合征(bronchiolitis obliterans syndrome,BOS)是最常见的慢性肺移植物失功能的非感染形式。近年来,疾病早期0p期肺功能筛查、薄层CT扫描图像的小气道重建技术、3He-MRI等其他影像学检查技术、支气管肺泡灌洗液来源生物标志物等诊断方式近年来取得一定进展,目前对该类疾病认识有了较大更新。预防性使用阿奇霉素、再次肺移植以及脐血来源间充质干细胞等许多有潜力的治疗方式已经出现。BOS的综合诊断方式和潜在治疗策略的进展为该类疾病发生、发展的早期监测和管理提供了更多理论参考和见解。

关键词: 慢性肺移植物失功能, 闭塞性细支气管炎综合征, 慢性移植物抗宿主病

Abstract:

Bronchiolitis obliterans syndrome(BOS) is the most common non-infectious form of chronic lung allograft dysfunction. In recent years, diagnosis methods such as screening studies of lung function in the early 0p stage of the disease, small airway reconstruction techniques with thin-layer CT scan images, 3He-MRI and other imaging examination technique, and bronchoalveolar lavage-derived biomarkers are used, to make the understanding BOS to improve a lot. In terms of therapeutic strategies, many promising treatment modalities such as prophylactic azithromycin use, lung re-transplantation, and umbilical cord blood-derived mesenchymal stem cells have been applied. These advances in diagnostic methods and therapeutic strategies for occlusive bronchiolitis obliterans syndromes provide more theoretical references and insights into the early monitoring and management of the development of the disease.

Key words: Chronic lung transplant dysfunction, Bronchiolitis obliterans syndrome, Chronic graft versus host disease

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