周明遠(yuǎn)

DOI：10.16662/j.cnki.1674-0742.2017.07.068

[摘要] 目的 探討結(jié)締組織病相關(guān)的肺間質(zhì)病變的臨床特點(diǎn)。方法 回顧性分析該院呼吸內(nèi)科于2010年6月—2015年6月期間確診的結(jié)締組織病合并肺間質(zhì)病變患者20例，分析臨床特點(diǎn)、實(shí)驗(yàn)室檢查及影像學(xué)表現(xiàn)。結(jié)果 20例患者均以肺部病變?yōu)槭装l(fā)、主要表現(xiàn)，多以干咳和隱匿性呼吸困難起病，入院診斷為肺部感染、間質(zhì)性肺炎10例，誤診率50.00%；自身抗體陽(yáng)性12例，占60.00%，多器官系統(tǒng)受累14例，占70.00%。結(jié)論 起病初期，結(jié)締組織病有關(guān)肺間質(zhì)病變表現(xiàn)不明顯，誤診率較高，盡早行HRCT掃描，結(jié)合結(jié)締組織病有關(guān)的肺間質(zhì)病變的臨床特點(diǎn)有利于早期診斷，及時(shí)治療干預(yù)改善病情。

[關(guān)鍵詞] 結(jié)締組織病；肺間質(zhì)病變；臨床特點(diǎn)；分析

[中圖分類號(hào)] R593.2 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 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(jié)締組織?。碈TD）造成人體肺損害類型主要包括肺間質(zhì)發(fā)生病變（即ILD）、細(xì)支氣管炎以及肺部動(dòng)脈高壓等，在這之中ILD是最為常見且可能對(duì)患者的預(yù)后產(chǎn)生最大影響的病變類型[1]。該文對(duì)該院呼吸內(nèi)科于2010年6月—2015年6月期間確診的20例結(jié)締組織病合并肺間質(zhì)病變患者的臨床特征進(jìn)行了總結(jié)和分析，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料

隨機(jī)擇取該院呼吸內(nèi)科收治的結(jié)締組織病合并肺間質(zhì)病變患者20例，其中男性12例，女性8例，年齡38～75歲之間，病程3周～6個(gè)月之間。20名患者中包括類風(fēng)濕性關(guān)節(jié)炎7例、干燥癥5例、系統(tǒng)性的紅斑狼瘡2例、皮肌炎2例、系統(tǒng)硬化癥2例，混合型結(jié)締組織病2例。

1.2 方法

對(duì)20例患者的臨床資料進(jìn)行回顧性的分析，觀察其臨床表現(xiàn)、治療轉(zhuǎn)歸以及影像學(xué)轉(zhuǎn)變情況。該組20例患者中，有10例患者存在咳嗽、咳痰等癥狀，有8例活動(dòng)后存在胸悶氣短癥狀，有10例存在肺部啰音。伴有多系統(tǒng)受累14例，其中發(fā)熱5例、關(guān)節(jié)痛11例、關(guān)節(jié)畸形4例、近端肌無(wú)力2例、皮膚損害3例、雷諾現(xiàn)象3例、口干5例。自身抗體檢查：ANA（+）12例，抗dsDNA（+）2例，J0-1（+）3例，SSA（+）5例，SSB（+）5例，ANCA（+）2例，P-ANCA（+）2例。行皮膚肌肉活檢4例，唇腺活檢5例。