慢性肺间质疾病36例临床特点及肺功能分析

目的探讨慢性肺间质疾病（ILD）的临床特点及其临床意义。方法回顾性分析36例慢性肺间质性疾病的临床特点及肺功能结果。结果36例患者分特发性肺间质纤维化（IPF）组及继发性肺间质纤维化组。特发性肺间质纤维化（IPF）组20例（56％ILD）,继发性肺间质纤维化组16例（44％ILD）。IPF组年龄偏大,多数肺部有爆裂音,占38．9％,杵状指者占11．1％。高分辨率CT扫描（HRCT）表现比较典型。两组肺功能改变主要为限制性的通气障碍和弥散功能降低。IPF组肺活量（VC）和肺总量（TLC）较继发性组下降明显,P〈0．05。一氧化碳弥散量（DLCO）下降显著且早,是较敏感的基础肺功能指标。结论持发性肺间质纤维化和继发性肺间质纤维化的临床特征和肺功能各有特点;临床表现、胸部HRCT、肺功能及支气管镜检查对诊断ILD起重要作用。

Clinical characteristics of chronic interstitial lung disease and its pulmonary functional analysis

Objective To investigate the clinical characteristics of chronic interstitial lung disease （ILD） and its significance. Methods The clinical characteristics and pulmonary functions of 36 cases with ILD were analyzed retrospectively. Results 20 of 36 cases were idiopathic pulmonary fibrosis （IPF）, and the other 16 cases were secondary interstitial lung diseases. The everage age in IPF group was older than secondary ILD group （ P 〈 0.05）. Crackle were found in 70 percents of ILD （14/20） , and 20 percents with clubbed finger （4/20）. The presentations were very typical in HRCT photograph. The main changes of pulmonary function in the two groups were restrictive ventilatory functional disturbance and lower pulmonary diffusion function. The vital capacity （VC） and total lung capacity （TLC） of IPF patients were lower than secondary ILD, with significant difference （ P 〈 0. 05 ）. Carbon monoxide diffusion capacity （DLCO） decreased more early and significantly, it was a relatively sensitive index of basal pulmonary function. Conclusion IPF and secondary ILD have themselves characteristics in clinic and pulmonary function. Clinical features,HRCT of chest,pulmonary function and bronchoscopy play an important roles in diagnosis of ILD.