目的：分析结缔组织相关性间质性肺疾病(CTD-ILD)和特发性间质性肺疾病(IIP)合并肺血栓栓塞症(PTE)患者的临床特征。方法收集2011~2014年在广州呼吸疾病研究所住院的CTD-ILD合并PTE及IIP合并PTE的患者17例(ILD合并PTE组)，并募集同期肺通气功能相匹配的CTD-ILD及IIP共20例患者(单纯ILD组)作为对照，对其临床资料进行分析。并在此基础上再对比ILD合并PTE组中的CTD-ILD亚组及IIP亚组。结果①与单纯ILD组比较，在ILD合并PTE组中，患者出现近期新发呼吸困难或呼吸困难加重的发生率有增高的趋势；ILD合并PTE组的动脉血氧分压更低，分别为(76.4±22.3)mmHg和(63.4±19.2)mmHg(P<0.05)；气体交换功能(DLCO%预计值)更差，分别为(48.5±11.6)%和(37.9±12.8)%。②ILD合并PTE组中，CTD-ILD亚组和IIP亚组的平均年龄分别为(59.83±13.40)岁和(71.90±4.68)岁，病程中出现PTE症状的时间分别为(18.07±16.71)个月和(34.75±14.69)个月，CTD-ILD患者发病年龄更小(P<0.05)，病程中出现PTE症状的时间更短(P<0.05)；IIP亚组患者共5例(71.43%)出现下肢水肿，CTD-ILD亚组中没有患者出现下肢水肿；IIP亚组中3例(30.00%)患者长期口服糖皮质激素，而CTD-ILD亚组共5例(71.43%)患者长期口服糖皮质激素。结论 ILD合并PTE可使患者气体交换功能障碍进一步加重，CTD本身的发生进展和长期口服糖皮质激素是PTE发生的高危因素。与IIP合并PTE比较，CTD-ILD合并PTE患者起病年龄更小，出现PTE的病程更短。%Objective To study the clinical characteristics of pulmonary thromboembolism in connective tissue disease related interstitial lung disease (CTD-ILD) and the idiopathic interstitial pneumonia (IIP) respectively. Methods From 2011 to 2014, 17 ILD (CTD-ILD and IIP) patients with pulmonary thromboembolism (PTE) in Guangzhou Institute of Respiratory Disease were retrospectively analyzed. 20 simplex ILD (CTD-ILD and IIP) patients with well-matched lung function were also recruited as control group during the same period. The clinical data and symptoms were summarized and statistically calculated. And a further analysis of clinical difference between CTD-ILD with PTE subgroup and IIP with PTE subgroup was followed. Results ①Compared with simplex ILD group, incidence of new dyspnea or aggravation of dyspnea was higher in ILD with PTE group; arterial partial pressure of oxygen was significantly lower in ILD with PTE group (P< 0.05), which were (76.4±22.3) mmHg and (63.4±19.2) mmHg respectively. And a significant lower pulmonary diffusion function (DLCO% of the predicted values) was found in ILD with PE group, which were (48.5±11.6)% and (37.9±12.8)% respectively (P< 0.05). ②In ILD with PTE group, average age of CTD-ILD and IIP subgroups were (59.83±13.40) years and (71.90±4.68) years The occurrence of PTE were (18.07±16.71) months and (34.75±14.69) months. It indicated that the age at onset of CTD-ILD was younger than IIP (P < 0.05), and the occurrence of PTE during ILD course was earlier than IIP. No patients of CTD-ILD subgroup had edema of lower limbs, while 5 patients (71.43%) of IIP subgroup had the symptom. 3 patients (30.00%) of IIP subgroup had oral adminstration of corticosteroids histories, while 5 patients (71.43%) of CTD-ILD subgroup had oral adminstra-tion of corticosteroids histories. Conclusion Association of PTE can aggravate pulmonary diffusion dysfunction. Occu-rance and progression of CTD and long-term oral adminstration of corticosteroids are all high risk factors of PTE. Compared with IIP patients with PTE, CTD-ILD patients with PTE are younger and have a shorter course of PTE onset.
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