103例间质性肺疾病临床特点分析修改.docVIP

103例间质性肺疾病的临床特点分析 研究生：张灿花 导师：何元兵副教授 摘 要 目的 分析间质性肺疾病的临床特点、肺功能、血气分析、影像学检查及实验室检查结果，以期为间质性肺疾病（ILD）的临床诊断提供依据。方法 回顾性分析我院2008年1月至2010年12月资料完整临床确诊的103例间质性肺疾病的临床资料。结果 103例间质性肺疾病的病例中以特发性间质性肺疾病所占比例最多，其次为慢性阻塞性肺病（chronic obstructive pulmonary disease，COPD)合并间质性肺疾病、结缔组织病合并间质性肺疾病,有吸烟史者40例。突出的临床表现为干咳、进行性呼吸困难伴（或）喘息，特发性间质性肺疾病较继发性间质性肺疾病更易出现爆裂音、杵状指两组比较差异有统计学意义（P0.05）；影像学上,网格状改变特发性间质性肺疾病较继发性间质性肺疾病多,P0.05；继发性间质性肺疾病较多出现胸膜受累P0.05，特发性间质肺疾病多为限制性通气功能障碍及弥散功能障碍，继发性间质性肺疾病多为限制性通气功能障碍为主的混合性通气功能障碍。103例患者的血气分析结果示32例患者有低氧血症，28例患者有Ⅰ型呼吸衰竭，2例患者有Ⅱ型呼吸衰竭。特发性间质性肺病合并肺动脉高压者8例，占特发性间质性肺疾病的15.69%，继发性间质性肺病合并肺动脉高压者27例，两组比较，继发性间质性肺病比特发性间质性肺病更易出现肺动脉高压，差别有统计学意义。结论 根据患者临床症状、体征、肺功能、血气分析、影像学检查及实验室检查结果可初步临床诊断间质性肺疾病。 关键词 间质性肺疾病 临床表现 血气分析 肺功能 影像 Clinical analysis of 103 patients with interstitial lung diseases Postgraduate: Canhua Zhang Supervisor: Prof. Yuanbing He associate professor ABSTRACT Objective: To analyze the clinical features, Pulmonary function test, blood gas analy- sis, radiography, laboratory tests of the patents with interstitial lung diseases ( ILD), The aim of this study was to help us know ILD well ,and diagnosis them properly. Methods: A total of 103 ILD patients from January 2008 to December 2010 were included in this study. Their clinical symptoms ,physical signs,pulmonary function, arterial blood gas and computed tomographs (CT) or high resolution computed tom- ographs (HRCT) of the chest were analyzed and compared. Results:Among 103 patients ,the ratio of idiopathic Interstitial lung disease ( IILD) was the highest, followed by chronic obstructive pulmonary disease (COPD) ,connective tissue diseases complicating ILD. Main symptoms were dry cough, insidious onset of progressive dyspnea or pant, cracks and finger clubbing showed more severe in idiopathic Interstitial lung disease than secondary interstitial lung diseases (SILD), P0.05.The most common Radio graghic findings were bibasilar reticular patterns and showed more severe in IILD groups than in SILD groups ,P0