皮肌炎 多发性肌炎患者间质性肺病病理资料推断陛分析  

The clinical characteristics of interstitial lung disease in patients with dermatomyositis and polymyositis

作　　者：王培珍[1,2] 管剑龙[1] 鲍礼智[1] 李金明[3] 韩星海[1] 

机构地区：[1]第二军医大学附属长海医院风湿免疫科,上海200433 [2]山东省临沂市人民医院干部病房,276000 [3]山东省临沂市人民医院干部病房

出　　处：《中华风湿病学杂志》2008年第12期826-828,共3页Chinese Journal of Rheumatology

摘　　要：目的分析皮肌炎（DM）、多发性肌炎（PM）合并间质性肺病（ILD）患者的胸部X线、胸部高分辨CT（HRCT）及肺功能等肺部表现临床特点及其预后。方法回顾性分析上海长海医院风湿免疫科1999年1月至2007年1月期间收住院的33例DM／PM合并ILD除外感染患者的临床资料。结果33例ILD患者经胸部X线及HRCT证实。根据临床-影像学特点并结合血气分析、肺功能测定，参照美国胸科学会和欧洲呼吸协会间质性肺炎的分类诊断标准，推断分析病理类型主要为非特异性间质性肺炎（NSIP）（57％）和寻常性间质性肺炎（UIP）（25％）。UIP类型预后差、病死率高（70％）。结论结合患者的影像学资料、肺功能、血气分析推断病理类型主要为NSIP和UIP，其中UIP病死率高、预后差。Objective To analyze the clinical features and prognosis of the interstitial lung disease （ILD） in patients with dermatomyositis （DM） and polymyositis （PM） by chest X-ray, chest high-resolution CT scan （HRCT） and pulmonary lung function. Methods Thirty-three patients hospitalized with DM/PM associated ILD were retrospectively analyzed. Results Thirty-three patients with ILD were confirmed by HRCT. Abnormal pulmonary function tests were available in 82% of patients. Clinical-imaging analysis revealed that the pathological features of ILD were non-specific interstitial pneumonia （NSIP, 57% ） and unusual interstitial pneumonia （UIP, 25%）. UIP types showed a poor prognosis and high mortality （70%）. Conclusion This study shows that HRCT is more sensitive for the diagnosis of ILD than lung function tests and chest X-ray. Combined HRCT and chest X-ray with lung function tests and blood gas analysis have shown that the major pathological types of ILD are NSIP and UIP, in which UIP are associated with high mortality and poor prognosis.

关 键 词：多发性肌炎 皮肌炎 肺疾病 间质性 体层摄影术 X线计算机 

分 类 号：R686[医药卫生—骨科学]