Classification of Hypersensitivity Pneumonitis
Classification of Hypersensitivity Pneumonitis
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DOI：
10.1159/000189200
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发表时间：
2009-01-01
影响因子：
2.8
通讯作者：
Cormier, Yvon
中科院分区：
文献类型：
--
作者：
Lacasse, Yves;Selman, Moises;Cormier, Yvon
背景：无论致病抗原如何，过敏性肺炎（HP）通常分为“急性”、“亚急性”或“慢性”。由于没有广泛接受的标准来区分各个阶段，因此这种分类仍然存在相当大的混乱。本研究的目的是确定目前的 HP 分类是否真正反映了具有不同临床特征的患者类别。方法：使用从大型前瞻性多中心队列研究（HP 研究）获得的数据，在不进行预先判断的情况下，将一组 HP 患者分为临床模式差异最大的有限数量的类别（簇）。该聚类分析的结果与当前 HP 分类（急性、亚急性或慢性）进行了比较。结果：168 名患者纳入分析。 2 集群解决方案最适合数据。第 1 组患者（41 名患者）比第 2 组患者（127 名患者）有更多的复发性全身症状（寒战和身体疼痛），胸部 X 光片正常，后者在高分辨率计算机断层扫描（HRCT）上显示出明显更多的杵状指、低氧血症、肺功能测试限制性模式和纤维化。所有 p 值均为
Background: Regardless of the causative antigen, hypersensitivity pneumonitis (HP) is usually classified as 'acute', 'subacute' or 'chronic'. Considerable confusion still surrounds this classification because there are no widely accepted criteria to distinguish the various stages. The objective of this study was to determine whether the current classification of HP truly reflects categories of patients with distinct clinical features. Methods: Data obtained from a large prospective multicenter cohort study (the HP Study) were used to divide a cohort of patients with HP into a limited number of categories (clusters) with maximally differing clinical patterns, without prejudgment. The results of this cluster analysis were compared with the current classification of HP (acute, subacute or chronic). Results: 168 patients were included in the analysis. A 2-cluster solution best fitted the data. Patients in cluster 1 (41 patients) had more recurrent systemic symptoms (chills and body aches) and normal chest radiographs than those in cluster 2 (127 patients) who showed significantly more clubbing, hypoxemia, restrictive patterns on pulmonary function tests and fibrosis on high- resolution computed tomography (HRCT). All p values were