结缔组织病相关肺间质病变73例临床剖析.docVIP

结缔组织病相关肺间质病变73例临床剖析 　　[摘要] 目的 分析结缔组织病相关肺间质病变（CTD-ILD）患者的临床特征。方法 回顾性分析本院2008 年1月～2012年6月住院并被确诊为CTD-ILD 的73例患者的临床资料。结果CTD-ILD病变发病率中类风湿关节炎（RA）所占比例最高，其后依次为系统性硬化症（SSc）、多发性肌炎/皮肌炎（PM/DM）、系统性红斑狼疮（SLE）和原发性干燥综合征（pSS），以上5种CTD占全部CTD-ILD的82.2%。呼吸道症状以活动后气促、咳嗽、胸部不适为主，约4.1%的患者可无明显呼吸道症状。肺功能检查以限制性通气功能障碍、弥散功能障碍为主，分别占检查者比例的61.0%和58.5%。胸片对CTD-ILD的检出率较高，约为93.2%。经糖皮质激素及其他免疫抑制剂的治疗，CTD-ILD患者死亡率约为9.6%。结论 对有呼吸道症状的CTD患者应尽早进行检查以排除合并ILD的可能，而胸片可作为ILD的筛查项目，结合肺功能检查可提高CTD-ILD的检出率，而HRCT检查则有利于早期诊断。早期发现并应用免疫抑制剂治疗是改善CTD-ILD预后的关键。 　　[关键词] 结缔组织病；肺间质病变；临床症状 　　[中图分类号] R56 [文献标识码] B [文章编号] 1674-4721（2013）07（a）-0185-03 　　Clinical features analysis of 73 cases of connective tissue disease-related interstitial lung diseases 　　GUO Dong-mei 　　Department of Rheumatology，the First Peoples Hospital of Foshan City in Guangdong Province，Foshan 528000，China 　　[Abstract] Objective To analyze the clinical characteristics of patients with interstitial connective tissue disease-related lung disease（CTD-ILD）. Methods the clinical data of 73 patients who were diagnosed as CTD-ILD in our hospital from January 2008 to June 2012 was analyzed retrospectively. Results RA accounted for the highest proportion of CTD-ILD，followed by SSc，PM/DM，SLE and pSS，and these five kinds of CTD accounted for 82% of all the CTD-ILD.The respiratory symptoms were mainly as shortness of breath after movement，cough and chest discomfort，about 6.8% of the patients had no significant respiratory symptoms.Pulmonary function tests mainly showed a restrictive ventilatory dysfunction and diffuse dysfunction，which accounted for 61% and 59% of the proportion.Chest X-ray could make higher detection rate of CTD-ILD，which was about 93.1%.After treated by glucocorticoids and other immunosuppressants，the mortality rate of CTD-ILD patients was about 9.6%.Conclusion CTD patients with respiratory symptoms should be checked as soon as possible to exclude ILD，and chest X-ray can be used as the ILD screening project.Pulmonary function tests can improve the detec