B.A.İ.B.Ü. Tıp Fakültesi Göğüs Hastalıkları Anabilim Dalına 1 ocak 2018 – 1 ocak 2019 tarihleri arasında başvuran interstisyel akciğer hastalıklarının incelenmesi
Küçük Resim Yok
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bolu Abant İzzet Baysal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İnterstisyel akciğer hastalıkları (İAH) , birçok akut ve kronik akciğer hastalığını kapsamaktadır. Çalışmamızda Abant İzzet Baysal Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Anabilim Dalı'na 1 Ocak 2018 ve 1 Ocak 2019 tarihleri arasında başvuran interstisyel akciğer hastalığı olarak değerlendirilen hastaların klinik, radyolojik ve demografik özelikleri ile tanı alma yöntemleri ve tedavi şekillerini değerlendirmeyi amaçladık. Yeni İAH tanısı alan 92 hastayı dahil ettiğimiz çalışmamızda hastaları tanı gruplarına göre değerlendirip tanı koyma yöntemleri ve uygulanan tedavi şekillerini ele aldık. Hastalarımızın 23'i ( % 25) kadın , 69'u (%75 ) erkek olup , yaş ortalaması 62.23 ± 11.78 (32-88 ) idi. En fazla görülen başvuru şikayetinin nefes darlığı (% 77.6) ve öksürük (%64.7) olduğu görüldü. Fizik muayene bulguları incelendiğinde en sık ince ral (%61) ve çomak parmak (%23) saptandı. Hastaların tanılarına bakıldığında; 23 hastaya idiyopatik pulmoner fibrozis (%25), 14 hastaya nonspesifik interstisyel pnömoni (% 15.2), 14 hastaya pnömokonyoz (%15.2), 10 hastaya sarkoidoz (%10.8) , 7 hasta hipersensitivite pnömonisi (%7.6), 6 hastaya ilaca bağlı akciğer hastalıkları (%6.5), 6 hastaya kollajen doku hastalığına bağlı interstisyel akciğer hastalığı (%6.5), 5 hastaya langerhans hücreli histiositozis (%5.4), 4 hasta respiratuar akciğer hastalığı (%4.3), 2 hastaya lenfosittik interstisyel pnömoni (%2.1), 1 hastaya kriptojenik organize pnömoni (%1.0) tanısı kondu. Solunum fonksiyon testleri incelendiğinde ortalama FEV1 değeri %77.38 ± 19.54 , FVC değeri 83.76 ± 20.07 , FEV1/FVC oranı 74.45 ± 11.09 olarak saptandı. DLCO ortalama değeri 56.56 ± 21.63 olarak bulundu. Tanı yöntemleri değerlendirildiğinde; 72 hastaya klinik ve radyolojik yöntemle (%78.3), 10 hastaya videotorakoskopi (VATS) ile (%10.9) , 7 hasta mediastinoskopi (MX) ile (%7.6) , 3 hastada bronkoskopik tanı yöntemleri ile (%3.3) tanı konulmuştur. Hastalara uygulanan tedavi şekillerine bakıldığında %29.3 steroid tedavisi , %18.5 antifibrotik tedavi başlandığı, %35.9'nun ise ilaçsız takip edildiği; geri kalanlara ise semptomatik ve inhaler tedavi verildiği görüldü. Sonuç olarak İAH, göğüs hastalıkları polikliniğine başvuran hastaların yaklaşık %15'ini oluşturmaktadır ve ayırıcı tanıda göz önünde bulundurulmalıdır. Çalışmamızda literatürde olduğu gibi en sık İPF , sarkoidoz, pnömokonyoz görülmüştür. Tanı koymada zorluklar olmakla birlikte radyolojik teknikler ve biopsi yöntemlerinin artması ile daha kolay tanı konulabilmektedir .
Interstitial lung disease (ILD) covers many acute and chronic lung diseases. In our study, we aimed to evaluate the clinical, radiological and demographic features, including methods of diagnosis, and treatment of patients who were evaluated as interstitial lung disease between 1 January 2018 and 1 January 2019. A totally of 92 patients included in our study were diagnosed with ILD and admitted at the Department of Lung Diseases, Abant İzzet Baysal University, Faculty of Medicine. 23 (25%) of our patients were female and 69 (75%) were male, and the mean age was 62.23 ± 11.78 (32-88). The most common complaints were dyspnea (77.6%) and cough (64.7%). When the physical examination findings were examined, thin ral (61%) and clubbing (23%) were the most common. As a result of evaluation of the patients are: Idiopathic pulmonary fibrosis (25%) in 23 patients, nonspecific interstitial pneumonia in 14 patients (15.2%), pneumoconiosis in 14 patients (15.2%), sarcoidosis in 10 patients (10.8%), 7 patients hypersensitivity pneumonia (7.6%), drug-bound lung in 6 patients diseases (6.5%), 6 patients interstitial lung disease due to collagen tissue disease (6.5%), 5 patients langerhans cell histiocytosis (5.4%), 4 patients respiratory lung disease (4.3%), 2 patients lymphocytic interstitial pneumonia (2.1%), One patient was diagnosed with cryptogenic organized pneumonia (1.0%). When the respiratory function tests were examined, the average FEV1 value was 77.38 ± 19.54%, the FVC value was 83.76 ± 20.07, and the FEV1 / FVC ratio was 74.45 ± 11.09. DLCO mean value was found as 56.56 ± 21.63. When the diagnostic methods are evaluated; 72 patients were diagnosed by clinical and radiological methods (78.3%), 10 patients by videothoracoscopy (VATS) (10.9%), 7 patients by mediastinoscopy (MX) (7.6%), and 3 patients by bronchoscopic diagnostic methods (3.3%). Considering the treatment methods applied to patients, 29.3% steroid treatment, 18.5% antifibrotic treatment, 35.9% were followed up without any medication; the rest were treated symptomatically with inhaler. Finally, from our study, ILD constitutes approximately 15% of patients admitted at lung diseases outpatient clinic and should be considered in the differential diagnosis. In our study, IPF, sarcoidosis, pneumoconiosis were seen most frequently, as in the literature. Although there are difficulties in diagnosis, it is easier to diagnose with the increase of radiological techniques and biopsy methods.
Interstitial lung disease (ILD) covers many acute and chronic lung diseases. In our study, we aimed to evaluate the clinical, radiological and demographic features, including methods of diagnosis, and treatment of patients who were evaluated as interstitial lung disease between 1 January 2018 and 1 January 2019. A totally of 92 patients included in our study were diagnosed with ILD and admitted at the Department of Lung Diseases, Abant İzzet Baysal University, Faculty of Medicine. 23 (25%) of our patients were female and 69 (75%) were male, and the mean age was 62.23 ± 11.78 (32-88). The most common complaints were dyspnea (77.6%) and cough (64.7%). When the physical examination findings were examined, thin ral (61%) and clubbing (23%) were the most common. As a result of evaluation of the patients are: Idiopathic pulmonary fibrosis (25%) in 23 patients, nonspecific interstitial pneumonia in 14 patients (15.2%), pneumoconiosis in 14 patients (15.2%), sarcoidosis in 10 patients (10.8%), 7 patients hypersensitivity pneumonia (7.6%), drug-bound lung in 6 patients diseases (6.5%), 6 patients interstitial lung disease due to collagen tissue disease (6.5%), 5 patients langerhans cell histiocytosis (5.4%), 4 patients respiratory lung disease (4.3%), 2 patients lymphocytic interstitial pneumonia (2.1%), One patient was diagnosed with cryptogenic organized pneumonia (1.0%). When the respiratory function tests were examined, the average FEV1 value was 77.38 ± 19.54%, the FVC value was 83.76 ± 20.07, and the FEV1 / FVC ratio was 74.45 ± 11.09. DLCO mean value was found as 56.56 ± 21.63. When the diagnostic methods are evaluated; 72 patients were diagnosed by clinical and radiological methods (78.3%), 10 patients by videothoracoscopy (VATS) (10.9%), 7 patients by mediastinoscopy (MX) (7.6%), and 3 patients by bronchoscopic diagnostic methods (3.3%). Considering the treatment methods applied to patients, 29.3% steroid treatment, 18.5% antifibrotic treatment, 35.9% were followed up without any medication; the rest were treated symptomatically with inhaler. Finally, from our study, ILD constitutes approximately 15% of patients admitted at lung diseases outpatient clinic and should be considered in the differential diagnosis. In our study, IPF, sarcoidosis, pneumoconiosis were seen most frequently, as in the literature. Although there are difficulties in diagnosis, it is easier to diagnose with the increase of radiological techniques and biopsy methods.
Açıklama
Tıp Fakültesi, Göğüs Hastalıkları Ana Bilim Dalı
Anahtar Kelimeler
Göğüs Hastalıkları, Chest Diseases
