Respiratory investigation最新文献_第5页

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-12-04 DOI: 10.1016/j.resinv.2025.101343

Chikashi Iwasaki , Kumi Nakaya , Mitsuhiro Yamada , Naoki Nakaya , Mana Kogure , Rieko Hatanaka , Ippei Chiba , Masato Takase , Sayuri Tokioka , Taku Obara , Masatsugu Orui , Naoya Fujino , Akira Koarai , Tomoko Kobayashi , Yohei Hamanaka , Eiichi N Kodama , Satoshi Nagaie , Soichi Ogishima , Nobuo Fuse , Shinichi Kuriyama , Atsushi Hozawa

Background

Preserved ratio impaired spirometry (PRISm), defined as a forced expiratory volume in 1 s (FEV₁) to forced vital capacity (FVC) ratio ≥0.70 and a predicted FEV₁ <80 %, is associated with increased morbidity and mortality. However, determinants of PRISm, particularly in younger populations, remain poorly characterised. We aimed to address this knowledge gap.

Methods

We conducted a cross-sectional analysis of 12,350 participants from a Japanese community-based cohort using data from the Tohoku Medical Megabank Project. Participants underwent spirometry, blood pressure measurement, laboratory testing, and completed standardised questionnaires. Multivariate logistic regression was used to identify factors associated with PRISm across three age groups: 20–39, 40–59, and ≥60 years. Interactions between age groups and other explanatory variables were assessed.

Results

In the 20–39-year group, PRISm was independently associated with being men, diabetes mellitus, hypothyroidism, and low body mass index (BMI <18.5 kg/m²), and inversely associated with age. Among participants aged ≥60 years, PRISm was significantly associated with increasing age, overweight status (BMI ≥25.0–<30.0 kg/m²), being men, current smoking, hypertension, diabetes mellitus, bronchial asthma, elevated eosinophil counts (≥300 cells/μL), and birth weight ≥2000–<2500 g. Significant interactions were observed between age and BMI, bronchial asthma, and thyroid dysfunction.

Conclusions

Our findings indicate that PRISm in younger adults is associated with hypothyroidism and underweight status, whereas in older adults, it is more closely related to constitutional and lifestyle-related factors. These results highlight the heterogeneity of PRISm and indicate that its pathophysiology and optimal management may vary by age group.

保留比例肺功能受损（PRISm），定义为1秒内用力呼气量（FEV1）与用力肺活量（FVC）之比≥0.70，预测FEV1≥80%，与发病率和死亡率增加相关。然而，PRISm的决定因素，特别是在年轻人群中，仍然缺乏特征。我们的目标是解决这一知识差距。方法我们对来自日本社区队列的12,350名参与者进行了横断面分析，数据来自东北医疗大银行项目。参与者接受肺活量测定、血压测量、实验室测试，并完成标准化问卷调查。多因素logistic回归用于确定三个年龄组（20-39岁、40-59岁和≥60岁）与PRISm相关的因素。评估了年龄组和其他解释变量之间的相互作用。结果在20 - 39岁组中，PRISm与男性、糖尿病、甲状腺功能减退、低体重指数（BMI <18.5 kg/m2）独立相关，与年龄负相关。在年龄≥60岁的参与者中，PRISm与年龄增长、超重状态（BMI≥25.0 - 30.0 kg/m2）、男性、当前吸烟、高血压、糖尿病、支气管哮喘、嗜酸性粒细胞计数升高（≥300个细胞/μL）和出生体重≥2000 - 2500 g显著相关。观察到年龄与BMI、支气管哮喘和甲状腺功能障碍之间存在显著的相互作用。结论青壮年PRISm与甲状腺功能减退、体重过轻有关，而老年人PRISm与体质、生活方式等因素关系更密切。这些结果突出了PRISm的异质性，并表明其病理生理和最佳管理可能因年龄组而异。

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引用次数: 0

BRAF V600E-mutant squamous cell carcinoma of the lung in patients with a history of papillary thyroid carcinoma: A three-case series 有甲状腺乳头状癌病史的患者的BRAF v600e突变型肺鳞状细胞癌：三例系列

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-12-01 DOI: 10.1016/j.resinv.2025.101344

Naozumi Hashimoto , Ryoma Moriya , Ken Akao , Hisashi Kako , Yasuhiro Goto , Tomohide Souma , Yuko Oya , Yuka Kondo , Tetsuya Tsukamoto , Sumito Isogai , Masashi Kondo , Kazuyoshi Imaizumi

There is limited data on BRAF V600E-mutant squamous cell carcinoma (SCC). We report three cases of SCC of the lung with a history of resected papillary thyroid carcinoma (PTC), showing p40 positivity, TTF-1 negativity, and PAX8 expression. While treated as lung SCC, metastatic thyroid carcinoma was unconfirmed due to absence of PTC recurrence, clinicopathologic features consistent with primary lung origin, and unavailable archival PTC pathology. BRAF inhibitors yielded only transient responses, and outcomes were poor. These cases underscore the diagnostic and therapeutic value of multigene testing in SCC, highlighting the need to integrate detailed clinical history into precision oncology strategies.

关于BRAF v600e突变型鳞状细胞癌（SCC）的数据有限。我们报告3例肺SCC伴有切除的甲状腺乳头状癌（PTC）病史，显示p40阳性，TTF-1阴性，PAX8表达。在作为肺SCC治疗时，转移性甲状腺癌由于PTC未复发，临床病理特征与原发性肺起源一致，以及没有PTC病理档案而未得到证实。BRAF抑制剂只能产生短暂的反应，而且结果很差。这些病例强调了多基因检测在SCC中的诊断和治疗价值，强调了将详细的临床病史整合到精确的肿瘤学策略中的必要性。

引用次数: 0

Desaturation in the six-minute walk test predicts progressive pulmonary fibrosis in fibrotic interstitial lung disease 6分钟步行试验中的去饱和预测纤维化间质性肺疾病的进行性肺纤维化

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-29 DOI: 10.1016/j.resinv.2025.11.013

Reoto Takei , Jun Fukihara , Yasuhiko Yamano , Kensuke Kataoka , Tomoki Kimura , Fumiko Watanabe , Taiki Furukawa , Junya Fukuoka , Takeshi Johkoh , Yasuhiro Kondoh

Background

The 6-min walk test (6MWT) is a widely used functional test that assesses desaturation on exercise. However, the clinical impact of desaturation on progressive pulmonary fibrosis (PPF) has been insufficiently studied. We aimed to evaluate the association between desaturation and future progression in patients with fibrotic interstitial lung disease (FILD).

Methods

We retrospectively analysed consecutive patients with FILD from 2008 to 2015. Desaturation was defined as oxygen saturation measured by pulse oximetry (SpO₂) at the end of the 6MWT being less than 90 %. It was divided into two groups: mild (SpO₂ was 89 %) and moderate desaturation (SpO₂ was 88 % or less).

Results

Among 810 patients, 498 (61.5 %) had desaturation (45 mild and 453 moderate). Multivariable Cox proportional hazard analysis showed desaturation was associated with a higher mortality (HR: 1.69, 95 % CI: 1.37–2.08, p < 0.0001). Both mild and moderate desaturation were also associated with a higher mortality compared with no desaturation, although there was no significant difference between them. Multivariable logistic regression analysis showed that desaturation was associated with PPF in the overall cohort (OR: 2.20, 95 % CI: 1.59–3.05, p < 0.0001), in patients with idiopathic pulmonary fibrosis (IPF) (OR: 2.59, 95 % CI: 1.56–4.29, p = 0.0002), and in patients with non-IPF FILD (OR: 1.86, 95 % CI: 1.17–2.96, p = 0.0091).

Conclusions

Desaturation in the 6MWT was associated with future risk of progression in patients with newly diagnosed FILD.

6分钟步行测试（6MWT）是一种广泛使用的功能测试，用于评估运动时的去饱和。然而，去饱和对进行性肺纤维化（PPF）的临床影响尚未得到充分研究。我们旨在评估纤维化间质性肺疾病（field）患者去饱和与未来进展之间的关系。方法回顾性分析2008 - 2015年连续发生的field患者。去饱和定义为在6MWT结束时通过脉搏血氧仪（SpO2）测量的氧饱和度小于90%。分为轻度（SpO2为89%）和中度（SpO2为88%或以下）两组。结果810例患者中有498例（61.5%）发生过血饱和度过低，其中轻度45例，中度453例。多变量Cox比例风险分析显示，去饱和与较高的死亡率相关（HR: 1.69, 95% CI: 1.37-2.08, p < 0.0001）。与不去饱和相比，轻度和中度去饱和也与更高的死亡率相关，尽管两者之间没有显著差异。多变量logistic回归分析显示，在整个队列（OR: 2.20, 95% CI: 1.59-3.05, p < 0.0001）、特发性肺纤维化（IPF）患者（OR: 2.59, 95% CI: 1.56-4.29, p = 0.0002）和非IPF field患者（OR: 1.86, 95% CI: 1.17-2.96, p = 0.0091）中，去饱和与PPF相关。结论：6MWT的去饱和与新诊断的field患者未来的进展风险相关。

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引用次数: 0

Impact of hospitalization on health-related quality of life in patients receiving home oxygen therapy: Insights of the Japanese white paper on home respiratory care 2024 住院治疗对接受家庭氧疗患者健康相关生活质量的影响：日本家庭呼吸护理白皮书2024的见解

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-29 DOI: 10.1016/j.resinv.2025.101341

Satoshi Hamada , Jun Ueki , Toyohiro Hirai , Emika Sano , Keiko Hino , Megumi Ikeda , Susumu Sato , Toru Oga , Tomomasa Tsuboi , Hajime Kurosawa , Hiroo Wada , the Japanese White Paper on Home Respiratory Care 2024 working group

Background

There are no available data on the impact of hospitalization on health-related quality of life (HRQoL) in patients receiving home oxygen therapy (HOT). Thus, the present study aimed to examine the association between hospitalization and HRQoL in patients receiving HOT based on the results of the Japanese White Paper on Home Respiratory Care 2024.

Methods

Patients receiving HOT who completed the HRQoL section of the patient survey, assessed using the Short Form-8 (SF-8) questionnaire, were included in the analysis. This survey data were collected from December 2021 to March 2023. The SF-8 questionnaire comprised eight subitems and two summary scores (physical component summary [PCS] and mental component summary [MCS]). Hospitalization within the past year were evaluated, excluding those due to coronavirus disease 2019.

Results

Totally, 288 patients receiving HOT were examined. In the SF-8 questionnaire survey, all items except body pain and the two summary scores did not differ between patients with chronic obstructive pulmonary disease and those with interstitial lung disease. Patients who had history of hospitalization had lower scores in all eight subitems and in both summary scores than those who did not. Based on a stepwise multiple linear regression analysis, PCS (β = −0.14, p = 0.011) and MCS (β = −0.14, p = 0.014) scores were independently and negatively correlated with hospitalization.

Conclusions

A history of hospitalization was independently associated with reduced HRQoL in patients receiving HOT. Prospective studies are needed to clarify underlying mechanisms and to evaluate interventions that may minimize HRQoL decline.

背景：目前尚无关于住院治疗对接受家庭氧疗（HOT）患者健康相关生活质量（HRQoL）影响的数据。因此，本研究旨在基于日本家庭呼吸护理白皮书2024的结果，探讨住院与接受HOT患者HRQoL之间的关系。方法接受HOT治疗的患者完成患者调查的HRQoL部分，使用SF-8问卷进行评估，纳入分析。该调查数据收集于2021年12月至2023年3月。SF-8问卷包括8个小项目和2个综合得分（生理成分总结[PCS]和心理成分总结[MCS]）。评估了过去一年内的住院情况，但不包括因2019年冠状病毒病住院的情况。结果共检查HOT患者288例。在SF-8问卷调查中，慢性阻塞性肺疾病患者与间质性肺疾病患者除身体疼痛和两项总结得分外，其他项目均无差异。有住院史的患者在所有八个分项和两项综合得分上的得分都低于没有住院史的患者。经逐步多元线性回归分析，PCS评分（β = - 0.14, p = 0.011）和MCS评分（β = - 0.14, p = 0.014）与住院治疗呈独立负相关。结论住院史与热疗患者HRQoL降低独立相关。需要前瞻性研究来阐明潜在的机制，并评估可能使HRQoL下降最小化的干预措施。

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引用次数: 0

Bronchoscopic lung insufflation for post-transplant lobar atelectasis: Efficacy and a rare complication of cerebral gas embolism 支气管镜下肺充气治疗移植后肺大叶不张：疗效和脑气栓塞的罕见并发症

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-28 DOI: 10.1016/j.resinv.2025.101339

Yojiro Yutaka , Akira Matsumoto , Ichiro Sakanoue , Hidenao Kayawake , Satona Tanaka , Daisuke Nakajima , Hiroshi Date

Bronchoscopic lung insufflation (BLI) allows re-expansion of collapsed lung lobes after transplantation. Among 254 transplant cases at our center, two patients underwent BLI for lobar atelectasis. Case 1 had recurrent right middle-lobe collapse after initial recovery, and BLI under conscious sedation led to durable re-expansion without complications. Case 2 underwent BLI for right upper-lobe atelectasis but developed transient neurological deficits due to presumed cerebral gas embolism, despite initial re-expansion. Full recovery was achieved with supportive care. These cases highlight BLI as an effective treatment for post-transplant atelectasis, although rare but serious complications require careful monitoring.

支气管镜肺充气（BLI）允许移植后塌陷的肺叶重新扩张。在我们中心的254例移植病例中，有2例患者因肺叶不张而行BLI。病例1在初次恢复后复发右中叶塌陷，清醒镇静下的BLI导致持续的再扩张，无并发症。病例2因右上肺叶不张接受了BLI治疗，尽管最初再次扩张，但由于假定的脑气栓塞而出现了一过性神经功能障碍。在支持性护理下完全康复。这些病例强调BLI是移植后肺不张的有效治疗方法，虽然罕见但严重的并发症需要仔细监测。

引用次数: 0

A case of persistent pneumothorax after bronchoscopic lung volume reduction successfully treated with video-assisted thoracic surgery without removal of endobronchial valves 支气管镜下肺减容术后持续性气胸1例，经电视辅助胸外科手术治疗，无支气管内瓣切除

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-26 DOI: 10.1016/j.resinv.2025.101338

Tadashi Sakaguchi , Tomohito Tarukawa , Yoichi Nishii , Motoshi Takao , Osamu Hataji

With proper patient selection excluding collateral ventilation, bronchoscopic lung volume reduction (BLVR) with endobronchial valves (EBVs) offers significant benefits but increases pneumothorax risk. Prioritized management of persistent pneumothorax post-BLVR remains unclear, with both EBV removal and video-assisted thoracic surgery (VATS) considered options. We report a 76-year-old man with severe emphysema who developed persistent pneumothorax and subcutaneous emphysema after left upper lobe BLVR. Following the patient's wishes, VATS was performed instead of EBV removal, resulting in a favorable outcome without delaying BLVR benefits. Depending upon the situation and patient wishes, prioritizing VATS over valve removal may be a reasonable strategy.

通过适当的患者选择，排除侧支通气，支气管镜下肺减容术（BLVR）与支气管内瓣膜（ebv）可以提供显着的益处，但增加气胸风险。blvr后持续性气胸的优先处理尚不清楚，EBV切除和视频辅助胸外科手术（VATS）都是考虑的选择。我们报告一位76岁男性严重肺气肿，在左上肺叶BLVR后出现持续性气胸和皮下肺气肿。根据患者的意愿，采用VATS代替EBV切除，在没有延迟BLVR益处的情况下获得了良好的结果。根据情况和患者的意愿，优先进行VATS而不是瓣膜移除可能是一个合理的策略。

引用次数: 0

How to choose a biologic agent considering comorbidities of bronchial asthma 考虑支气管哮喘的合并症，如何选择生物制剂

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-26 DOI: 10.1016/j.resinv.2025.101337

Masamichi Itoga, Sadatomo Tasaka

Biologic therapies have revolutionized the treatment of severe asthma. However, the selection of the optimal biologic agent remains challenging because of the heterogeneity of disease phenotypes and frequent comorbidities. This mini-review explored the clinical relevance of comorbidities in the selection of biologics for patients with asthma.

Herein, we summarize recent evidence on the prevalence of comorbidities associated with type 2 inflammation, including chronic spontaneous urticaria, atopic dermatitis, prurigo nodularis, chronic rhinosinusitis with nasal polyps, eosinophilic granulomatosis with polyangiitis, eosinophilic otitis media, aspirin-exacerbated respiratory disease, allergic rhinitis, allergic bronchopulmonary mycosis, obesity, and chronic obstructive pulmonary disease, and review the efficacy of five major biologics (omalizumab, mepolizumab, benralizumab, dupilumab, and tezepelumab) in these settings. Each biologic targets distinct immunologic pathways in type 2 inflammation, including IgE, IL-5, IL-5Rα, IL-4Rα, and thymic stromal lymphopoietin, respectively.

In conclusion, the assessment of comorbidities in addition to biomarkers is essential for tailoring biologic therapies for severe asthma. Integrating comorbidity profiles into treatment strategies allows for a more precise and effective use of biologics, ultimately improving outcomes in complicated asthma cases.

生物疗法使严重哮喘的治疗发生了革命性的变化。然而，由于疾病表型的异质性和常见的合并症，选择最佳的生物制剂仍然具有挑战性。这篇小型综述探讨了哮喘患者选择生物制剂时合并症的临床相关性。在此，我们总结了最近与2型炎症相关的合并症患病率的证据，包括慢性自发性荨麻疹、特应性皮炎、结节性痒疹、伴鼻息肉的慢性鼻窦炎、伴多血管炎的嗜酸性肉芽肿病、嗜酸性中耳炎、阿司匹林加重的呼吸系统疾病、变应性鼻炎、过敏性支气管肺真菌病、肥胖和慢性阻塞性肺病。并回顾五种主要生物制剂（omalizumab, mepolizumab, benralizumab， dupilumab和tezepelumab）在这些情况下的疗效。在2型炎症中，每种生物制剂分别靶向不同的免疫途径，包括IgE、IL-5、IL-5Rα、IL-4Rα和胸腺基质淋巴生成素。总之，除了生物标志物外，评估合并症对于定制严重哮喘的生物疗法至关重要。将共病概况纳入治疗策略，可以更精确、更有效地使用生物制剂，最终改善复杂哮喘病例的预后。

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引用次数: 0

Successful tracheostomy tube removal following airway clearance using intrapulmonary percussive ventilation treatment after bilateral lung transplantation in a patient with idiopathic pleuroparenchymal fibroelastosis 特发性胸膜实质纤维弹性增生患者双侧肺移植术后使用肺内冲击通气清除气道后气管造口成功拔管一例

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-25 DOI: 10.1016/j.resinv.2025.101336

Satoshi Hamada , Tomohiko Yamaguchi , Yohei Oshima , Yoshihiro Nishino , Satona Tanaka , Daisuke Nakajima , Toyohiro Hirai

Sputum management is a critical and potentially lethal issue in patients following lung transplantation. Here, we describe a patient with idiopathic pleuroparenchymal fibroelastosis who underwent tracheotomy after deceased donor bilateral lung transplantation, in whom we were unable to remove the tracheostomy tube due to difficulty in sputum evacuation. The tube was successfully removed following the subsequent initiation of intrapulmonary percussive ventilation (IPV) treatment combined with pulmonary rehabilitation. IPV has been widely used for several decades for treating pulmonary conditions, including chronic obstructive pulmonary disease, cystic fibrosis, and bronchiectasis. However, it should also be considered for airway clearance after lung transplantation.

痰液管理是肺移植术后患者的一个关键和潜在的致命问题。在这里，我们描述了一个特发性胸膜实质纤维弹性增生患者，他在死亡的双侧供体肺移植后接受了气管切开术，由于痰液难以排出，我们无法取出气管切开术管。在随后开始肺内冲击通气（IPV）治疗并结合肺部康复后，成功拔出了管子。几十年来，IPV被广泛用于治疗肺部疾病，包括慢性阻塞性肺疾病、囊性纤维化和支气管扩张。然而，肺移植后气道清除也应考虑。

引用次数: 0

Incidence and clinical features of venous thromboembolism in patients with lung cancer in Japan: results from the CS-Lung-003 prospective observational registry study 日本肺癌患者静脉血栓栓塞的发生率和临床特征：CS-Lung-003前瞻性观察登记研究的结果

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-22 DOI: 10.1016/j.resinv.2025.11.011

Yukari Tsubata , Nobuhiro Kanaji , Mika Nakao , Takeshi Masuda , Masahiro Yamasaki , Masahiro Kodani , Nobuhisa Ishikawa , Toshiyuki Kozuki , Masaaki Inoue , Kazuya Nishii , Katsuyuki Hotta , Katsuyuki Kiura , Takeshi Isobe

Background

Venous thromboembolism (VTE) is a frequent complication of cancer-associated thrombosis, and its management is critical when considering cancer treatment selection and prognosis. The aim of this study was to investigate the incidence and risk factors for VTE in patients with lung cancer using the CS-Lung003 platform, a multicenter prospective observational study of advanced lung cancer.

Methods

Patients with a pathologic diagnosis of lung cancer at any stage were included. The incidence of VTE was calculated using the CS-Lung003 database, and risk factors were examined using logistic regression analysis.

Results

The analysis included 1744 patients (80 % male). Sixty patients (3.4 %) had VTE at/after enrollment in the CS-Lung003 trial. The median age was 69 years (range 63–76) in the group without VTE and 72 years (range 67–77) in the group with VTE. Adenocarcinoma was diagnosed in 58.7 % of patients in the group without VTE and 46.7 % in the group with VTE. Univariate analysis revealed male sex, body weight, and hypertension as risk factors for VTE. Overall survival was 29.1 months in the group without VTE and 30.6 months in the group with VTE. Among patients with stage IIIB–IV, the VTE group showed significantly longer overall survival compared with the non-VTE group (p = 0.041).

Conclusions

The incidence of VTE in this study was low, suggesting that there may have been patients with VTE complications that were not reported in the registry. In addition, most patients with VTE received therapeutic intervention; appropriate diagnosis and treatment may have allowed cancer treatment to continue. Appropriate diagnosis and treatment of VTE might allow lung cancer therapy continuation without compromising survival.

Clinical trial registry/registration number

UMIN-CTR/UMIN000026696.

静脉血栓栓塞（VTE）是癌症相关血栓形成的常见并发症，在考虑癌症治疗选择和预后时，其管理至关重要。本研究的目的是利用CS-Lung003平台，研究晚期肺癌多中心前瞻性观察性研究，探讨肺癌患者静脉血栓栓塞的发生率和危险因素。方法纳入病理诊断为肺癌的任何分期患者。采用CS-Lung003数据库计算静脉血栓栓塞发生率，采用logistic回归分析检查危险因素。结果纳入1744例患者，其中80%为男性。60名患者（3.4%）在CS-Lung003试验入组后出现静脉血栓栓塞。无静脉血栓栓塞组的中位年龄为69岁（63-76岁），有静脉血栓栓塞组的中位年龄为72岁（67-77岁）。无静脉血栓栓塞组的腺癌诊断率为58.7%，有静脉血栓栓塞组为46.7%。单因素分析显示，男性、体重和高血压是静脉血栓栓塞的危险因素。无静脉血栓栓塞组总生存期为29.1个月，有静脉血栓栓塞组总生存期为30.6个月。在IIIB-IV期患者中，VTE组的总生存期明显长于非VTE组（p = 0.041）。结论本研究中静脉血栓栓塞的发生率较低，提示可能存在未在登记中报告的静脉血栓栓塞并发症患者。此外，大多数VTE患者接受了治疗性干预；适当的诊断和治疗可能会使癌症治疗继续下去。适当的诊断和治疗静脉血栓栓塞可能使肺癌治疗继续而不影响生存。临床试验注册/注册号：umin - ctr /UMIN000026696。

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引用次数: 0

Psychological palliative care for patients with interstitial lung disease in Japan: A secondary analysis of a National Survey of Japanese Respiratory Physicians 日本间质性肺病患者的心理姑息治疗：对日本呼吸内科医生全国调查的二次分析

IF 2 Q2 RESPIRATORY SYSTEM

Respiratory investigation

Pub Date : 2025-11-20 DOI: 10.1016/j.resinv.2025.11.009

Yoshinobu Matsuda , Tomoyuki Fujisawa , Tatsuya Morita , Masanori Mori , Norimichi Akiyama , Takafumi Koyauchi , Mitsunori Miyashita , Ryo Tachikawa , Keisuke Tomii , Hiromi Tomioka , Satoshi Hagimoto , Yasuhiro Kondoh , Yoshikazu Inoue , Takafumi Suda

Background

Patients with interstitial lung disease (ILD) often experience psychological symptoms. This study aimed to clarify the status of psychological support for patients with ILD in Japan.

Methods

We conducted a secondary analysis on a nationwide survey of Japanese respiratory physicians to assess psychological support availability, consultation departments, reasons for palliative care referrals, and opinions on insurance coverage for psychologist-led psychotherapy.

Results

Of 1332 respondents, 1023 managed patients with ILD in the previous year. Among them, 34.5 % reported no psychological support availability and 42.9 % reported insufficient support. Psychiatry or psychosomatic medicine departments were consulted by 77.3 %, and palliative care teams by 52.2 %. Anxiety (47.4 %) and depression (44.6 %) were the reasons for palliative care referral. Overall, 93.6 % considered insurance coverage for psychologist-led psychotherapy helpful or essential.

Conclusions

Most physicians lack adequate psychological support resources for ILD despite frequent psychological symptoms. Systematic development of support structures and insurance coverage are needed.

背景：间质性肺疾病（ILD）患者常出现心理症状。本研究旨在了解日本ILD患者的心理支持状况。方法我们对日本全国呼吸内科医生的调查进行了二次分析，以评估心理支持的可获得性、咨询部门、姑息治疗转诊的原因以及对心理医生主导的心理治疗的保险覆盖范围的意见。结果在1332名应答者中，1023名在前一年治疗过ILD患者。其中34.5%的人表示没有心理支持，42.9%的人表示支持不足。精神科或心身内科就诊的占77.3%，姑息治疗小组就诊的占52.2%。焦虑（47.4%）和抑郁（44.6%）是患者转诊姑息治疗的原因。总体而言，93.6%的人认为心理医生主导的心理治疗的保险范围是有益的或必要的。结论大多数医生对ILD缺乏足够的心理支持资源，但心理症状频繁。系统地发展支持结构和保险是必要的。

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引用次数: 0