风湿病肺间质病变的临床特点

目的　探讨风湿性疾病并发肺间质病变的临床特点。方法　对 35例风湿性疾病并发肺间质病变的临床表现、影像学改变、肺功能检查、血气分析及经纤支镜肺活检病理学变化进行回顾性分析。结果　各种风湿性疾病并发肺间质病变中 ,6 0 %以原发疾病为首发症状 ;胸部影像学显示磨玻璃样、小结节状、网状及蜂窝状改变 ,以两侧中下肺外带为主 ;肺功能测定以限制性通气功能障碍及弥散功能降低为主 ;可出现不同程度低氧血症 ,无二氧化碳潴留 ;肺活检病理学显示肺泡间隔增宽 ,胶原沉积 ,纤维组织增生 ,少数淋巴细胞浸润。结论　风湿性疾病并发肺间质病变可以原发风湿性疾病或呼吸系统表现为首发症状 ,影像学改变是临床诊断的依据 ,肺活检可确诊肺部病变

CLINICAL FEATURE OF INTERSTITIAL LUNG DISEASE COMPLICATING RHEUMATOSIS

Objective\ To describe the clinical characteristics of interstitial lung involvement in patients with rheumatosis.Methods\ The 35 patients were analysed for the causes,clinical characteristics,radiographic changes(including high-resolution CT,arterial blood gases,lung function and lung biopsy specimens).Results\ 60% patients with interstitial lung involvements manifested original diseases at onset.Radiographic findings included ground-glass appearances,nodulus-reticular and honeycombing patterns.lung function test showed restrictive and diffusion reduction patterns.Blood gas analysis showed reduced PaO 2.Histologic changes of lung biopsy included alveolar interval incement,fibrosis and collogen sediment,with less lymphocytes infiltration.Conclusion\ Rheumatic disease may cause interstitial lung disease,with a certain clinical,radiographic,histologic characteristics.