124例结缔组织病相关性肺间质病变的临床特点和HRCT表现的回顾性分析  

Retrospective Analysis of Clinical Characteristics and HRCT Manifestations of 124 Patients with Connective Tissue Disease-Related Interstitial Lung Disease

作　　者：何杰 张秀萍 周维 廖小燕 彭澍 HE Jie;ZHANG Xiu-ping;ZHOU Wei;LIAO Xiao-yan;PENG Shu(Department of Radiology,the third Hospital of Changsha,Changsha 410015,Hunan Province,China)

机构地区：[1]长沙市第三医院放射影像科,湖南长沙410015

出　　处：《中国CT和MRI杂志》2022年第5期96-100,共5页Chinese Journal of CT and MRI

摘　　要：目的 回顾性分析结缔组织病相关性间质性肺疾病(CTD-ILD)患者的临床特点和高分辨电子计算机断层扫描(HRCT)表现。方法 回顾性分析2017年5月至2019年5月我院收治的124例CTD-ILD患者的临床资料,包括一般情况、临床表现、实验室检查、肺功能检查和肺部HRCT。结果 124例患者中,结缔组织病相关性间质性肺疾病包含类风湿关节炎(RA-ILD)16例(12.91%),系统性硬化症(SScILD)27例(21.77%),系统性红斑狼疮(SLE-ILD)11例(8.87%),多发性肌炎/皮肌炎(PM/DM-ILD)36例(29.03%),干燥综合征(SS-ILD)29例(23.39%),抗中性粒细胞胞质抗体相关性血管炎(AAV-ILD)5例(4.03%)。患者平均年龄(58.23±9.74)岁,其中SLEILD的平均年龄低于其他组(P<0.05)。患者临床症状中呼吸系统症状发生率高于全身和皮肤症状,并且velcro啰音发生率高于其他症状(P<0.05)。SLE-ILD患者的PLT低于其他各组(P<0.05);AAV-ILD患者的WBC高于其他各组、HB低于其他各组(P <0.05)。SSc-ILD、SS-ILD出现限制性通气功能障碍的比例高;PM/DM-ILD出现弥散功能障碍的比例高。肺部HRCT表现中,网格状影47例(37.90%),磨玻璃影83例(66.94%),实变影23例(18.55%),结节影39例(31.45%),囊状低密度影27例(21.77%)。RA-ILD网格状影发生率最高,SLE-ILD、AAV-ILD磨玻璃影发生率最高,SS-ILD囊状低密度影发生率最高。SScILD、PM/DM-ILD、AAV-ILD多表现为非特异性间质性肺炎(NSIP);RA-ILD多表现为寻常型间质性肺炎(UIP);SLE-ILD多表现为(AIP);SS-ILD多表现为NSIP和淋巴细胞间质性肺炎(LIP)。结论 肺部HRCT是协助临床医师诊断的重要工具,掌握各种类型CTD-ILD的临床特征和影像学特点,对早期诊断疾病,采取积极有效治疗措施,改善患者预后有重要临床意义。Objective To retrospectively analyze the clinical characteristics and High-resolution computer tomography(HRCT) manifestations of patients with connective tissue disease-related interstitial lung disease(CTD-ILD) were retrospectively analyzed. Methods The clinical data of 124 CTD-ILD patients admitted in our hospital from May 2017 to May 2019 were retrospectively analyzed, including general conditions, clinical manifestations, laboratory tests, pulmonary function tests and lung HRCT. Results Among the 124 patients, Connective tissue disease-related interstitial lung disease included 16 cases of rheumatoid arthritis(RA-ILD)(12.91%), 27 cases of systemicscleroderma(SSc-ILD)(21.77%), 11cases of systemic lupus erythematosus(SLE-ILD)(8.87%), 36 cases of polymyositis/dermatomyositis(PM/DM-ILD)(29.03%), 29 cases of siccasyndrome(SS-ILD)(23.39%), and 5 cases of anti-neutrophil cytoplasmic antibody associated vasculiti(AAV-ILD)(4.03%). The average age of patients was(58.23±9.74) years,The average age of SLE-ILD was lower than other groups(P<0.05). The incidence of respiratory symptoms was higher than that of systemic and skin symptoms, and the incidence of velcro rales was higher than other symptoms(P<0.05). The PLT of SLE-ILD patients was lower than other groups(P<0.05);the WBC of AAV-ILD patients was higher than that of other groups,and HB was lower than other groups(P<0.05). SSc-ILD and SS-ILD had a high proportion of restricted ventilation dysfunction;PM/DM-ILD had a high proportion of diffuse dysfunction. In the lung HRCT, 47(37.90%)were reticular shadows, 83(66.94%) were ground glass shadows, 23(18.55%) were solid shadows, 39(31.45%) were nodular shadows, and cystic low density 27(21.77%). RA-ILD had the highest incidence of reticular shadow, SLE-ILD, AAV-ILD ground glass shadow had the highest incidence, SS-ILD cystic low density shadow had the highest incidence. SSc-ILD, PM/DM-ILD, and AAV-ILD were mostly represented by nonspecific interstitial pneumonia(NSIP);RA-ILD was mostly represented by usual interstitial p

关 键 词：结缔组织病 间质性肺疾病 高分辨电子计算机断层扫描 

分 类 号：R563[医药卫生—呼吸系统] R593.2[医药卫生—内科学]