结缔组织病肺间质病变的临床特点及治疗效果分析

摘要

Objective To investigate the prevalence and clinical characters of connective tissue diseases- interstitial lung disease (CTD-ILD). Methods Eight-two patients with CTD-ILD were studied. Every patients had radiography and high-resolution computed tomography (HRCT). Results ( 1 ) ILD positive rate in SSc is 70. 0％, more than other CTDs. SLE-ILD patients are yungest ( 26. 2±7. 8 ). RA-ILD and SSc-ILD have longer course of disease than pSS-ILD, SLE-ILD and PM-ILD. RA-ILD espiratory symptoms are very light. 85.7％ SSc-ILD accompany with Raynaud's phenomenon. (2) Honey combing and mediastinal lymphadenectasis are the most imagings on the HRCT of pSS-ILD. Ground glass opacity was commonly seen in SLE-ILD. (3) compared images of HRCT, 56. 7％ cases responded to treatment, 28.4％ cases had no change, and 14.9％ cases grew worse. Conclusion Patients with CTD-ILD need to begin treatment once they are diagnosed.%目的 探讨不同结缔组织病肺间质病变(CTD-ILD)的临床特点和治疗效果.方法 分析82例CTD-ILD患者的临床特征及胸部高分辨CT(HRCT)特点并观察治疗后HRCT的变化.结果 (1) SSc-ILD的发生率最高,为70.0%.其次为pSS-ILD、PM/DM-ILD、RA-ILD、SLE-ILD,系统性红斑狼疮继发的ILD(SLE-ILD)发病年龄(26.2±7.8)较其他CTD-ILD早(P<0.05).RA-ILD、SSc-ILD病程较长,pSS-ILD、SLE-ILD和PM-ILD病程较短.RA-ILD出现活动后气促少见(P<0.05).pSS-ILD出现呼吸道症状(40%)和体征(50%)最多见.85.7% SSc-ILD出现雷诺现象,支持雷诺现象与ILD相关.(2)SLE-ILD以磨玻璃影多见,而蜂窝状改变较少;pSS-ILD以蜂窝状改变和纵隔淋巴结肿大相对较多.(3)大部分患者治疗后肺部间质病变吸收好转(56.7%),其中88.2% SLE-ILD吸收好转,28.4%患者肺部病变处于静止,14.9%患者间质病变较前进展.结论 CTD-ILD患者一旦确诊,应尽早用激素联合免疫抑制剂治疗.