结缔组织病相关的肺间质病变临床特点分析

周明远

DOI：10.16662/j.cnki.1674-0742.2017.07.068

[摘要] 目的 探讨结缔组织病相关的肺间质病变的临床特点。方法 回顾性分析该院呼吸内科于2010年6月—2015年6月期间确诊的结缔组织病合并肺间质病变患者20例，分析临床特点、实验室检查及影像学表现。结果 20例患者均以肺部病变为首发、主要表现，多以干咳和隐匿性呼吸困难起病，入院诊断为肺部感染、间质性肺炎10例，误诊率50.00%；自身抗体阳性12例，占60.00%，多器官系统受累14例，占70.00%。结论 起病初期，结缔组织病有关肺间质病变表现不明显，误诊率较高，尽早行HRCT扫描，结合结缔组织病有关的肺间质病变的临床特点有利于早期诊断，及时治疗干预改善病情。

[关键词] 结缔组织病；肺间质病变；临床特点；分析

[中图分类号] R593.2 [文献标识码] A [文章编号] 1674-0742（2017）03（a）-0068-03

Analysis of Clinical Features of Connective Tissue Disorder Related Interstitial Lung Disease

ZHOU Ming-yuan

Department of Respiration Medicine， Chuxiong Peoples Hospital， Chuxiong， Yunnan Province， 657000 China

[Abstract] Objective To discuss the clinical features of connective tissue disorder related interstitial lung disease. Methods 20 cases of patients with connective tissue disorder related interstitial lung disease diagnosed in our hospital from June 2010 to June 2015 were selected and the clinical features， laboratory examination and imaging performance were analyzed. Results The primary manifestation of all 20 patients was lung disease， onset of dry cough and latent dyspnea， and the admission diagnosis showed that there were 10 cases with lung infection and interstitial pneumonia， and the misdiagnosis rate was 50.00%， and there were 12 cases with positive autoantibody， accounting for 60.00% and 14 cases with multi- organ system involvement， accounting for 70.00%. Conclusion The manifestation of connective tissue disorder related interstitial lung disease is not obvious during the early stage with higher misdiagnosis rate， and conducting the HRCT scan early combined with the clinical features of connective tissue disorder related interstitial lung disease is conducive to the early diagnosis and treatment of disease in time.

[Key words] Connective tissue disorder； Interstitial lung disease； Clinical feature； Analysis

結缔组织病（即CTD）造成人体肺损害类型主要包括肺间质发生病变（即ILD）、细支气管炎以及肺部动脉高压等，在这之中ILD是最为常见且可能对患者的预后产生最大影响的病变类型[1]。该文对该院呼吸内科于2010年6月—2015年6月期间确诊的20例结缔组织病合并肺间质病变患者的临床特征进行了总结和分析，现报道如下。

1 资料与方法

1.1 一般资料

随机择取该院呼吸内科收治的结缔组织病合并肺间质病变患者20例，其中男性12例，女性8例，年龄38～75岁之间，病程3周～6个月之间。20名患者中包括类风湿性关节炎7例、干燥症5例、系统性的红斑狼疮2例、皮肌炎2例、系统硬化症2例，混合型结缔组织病2例。

1.2 方法

对20例患者的临床资料进行回顾性的分析，观察其临床表现、治疗转归以及影像学转变情况。该组20例患者中，有10例患者存在咳嗽、咳痰等症状，有8例活动后存在胸闷气短症状，有10例存在肺部啰音。伴有多系统受累14例，其中发热5例、关节痛11例、关节畸形4例、近端肌无力2例、皮肤损害3例、雷诺现象3例、口干5例。自身抗体检查：ANA（+）12例，抗dsDNA（+）2例，J0-1（+）3例，SSA（+）5例，SSB（+）5例，ANCA（+）2例，P-ANCA（+）2例。行皮肤肌肉活检4例，唇腺活检5例。