结缔组织病累及呼吸系统的影像特点

结缔组织病累及呼吸系统可表现为间质性肺疾病、弥漫性肺泡损伤、肺泡出血、肺血管病变、胸膜病变及气道病变等。其临床表现缺乏特异性,肺功能和胸部CT是最常用的检查手段。不同结缔组织病累及呼吸系统的影像特征具有相似性,但又各具特点。本文就结缔组织病呼吸系统受累相关影像表现进行概述,以提升读者的认知并指导临床实践。     

结缔组织病与军团菌病

本文报告少年类风湿关节炎全身型（Ｓｔｉｌｌ氏病），皮肌炎及系统性红斑狼疮各１例在治疗期间并发了军团菌病。两例系由嗜肺军团菌引起的庞蒂克热，一例为米克截德军团肺炎而死亡。复习文献就结缔组织病并发军团菌病进行讨论，认为结缔组织病患患者可能是军团菌病的高危人群。     

误诊为结缔组织病的结核病

【病例】　女 ,3 0岁。因发热 2周由外院转入。体温 3 9 0～40 6℃ ,伴全身酸痛 ,乏力 ,轻咳 ,无痰 ,当地医院予第三代头孢菌素、喹诺酮治疗效果不明显。既往体健 ,孕2 产1。否认结核病史和结核病接触史。查体未见异常体征。血白细胞 4 1× 10 9/Ｌ ,淋巴细胞 0 2 0 ,血红蛋白 89 9ｇ/Ｌ ,血小板 97× 10 9/Ｌ。尿蛋白(+ )。血白蛋白 2 5～ 2 8ｇ/Ｌ。胸部Ｘ线摄片未见明显异常。初步诊断 :发热待查 ,不除外结缔组织病。予头孢塞肟钠 2 0 ｇ ,每日 2次静脉滴注 ,治疗 4天。体温仍高达 40 5℃ ,予物理降温及非甾体类解热药后大量出汗 ,体…     

结缔组织病的发热特点及诊断、治疗

结缔组织病曾称胶原性疾病 ,系结缔组织广泛性、炎性变和纤维蛋白样物质沉积所致。与发热相关的小儿常见的结缔组织病有风湿热、幼年型类风湿性关节炎、系统性红斑狼疮、川崎病 ;少见的有血清病、幼年型皮肌炎、渗出性多形红斑、结节性多动脉炎、混合性结缔组织病、结节性脂膜炎、干燥综合征等。现述如下 :1　风湿热发热一般都不太高 ,且热型不规则 ,少数可见短期高热 ,多为长期持续性低热 ,持续约 3～ 4周 ,临床上以心脏炎 (心肌炎、心内膜炎、心包炎 ) ,多发性关节炎、舞蹈症、环形红斑、皮下结节为其特征 ,目前仍沿用修改的Jones风湿热…     

恙虫病的呼吸系统并发症

恙虫病是由恙虫病立克次体所引起的一种急性传染病,病原体侵入机体后可损害许多系统或脏器,而呼吸系统尤为突出,常常被误诊。现将我院收住420例恙虫病人中有呼吸系统并发症的168例(占40％)报道如下。 1 临床资料 1.1 一般资料:168例病人中,男88例,女80例,年龄1～80岁,平均年龄35岁。就诊前发病天数3～10天,平均6天。     

结缔组织病血小板减少的临床特点

结缔组织病（CTD）是一种主要侵犯全身结缔组织和血管的自身免疫性疾病,可累及全身各个系统,血液系统受累很常见,引起白细胞（WBC）、血红蛋白（Hb）及血小板（PLT）减少等。本研究通过回顾性总结在我院就诊的系统性红斑狼疮（SLE）,原发性干燥综合征（pSS）患者的资料,分析CTD引起PLT减少的临床特点及对治疗的反应,以提高临床医师对CTDPLT减少的认识。     

混合性结缔组织病的诊治

混合性结缔组织病发病并不少见,本病为临床上具有系统性红斑狼疮、系统性硬化症、多发性肌炎/皮肌炎及类风湿性关节炎等疾病混合表现,血清中有高滴度RNP抗体为特征。本文对混合性结缔组织病的发病机制、临床表现、诊断标准、治疗等予以介绍。     

Graves病合并混合性结缔组织病一例

1　临床资料患者女性 ,35岁 ,主因怕热、多汗、大便次数增多伴明显消瘦 2年 ,面部红斑 4月 ,加重半月余于 2 0 0 1年 6月收住我院。外院曾诊断甲亢 ,不规则服药 ,疗效欠佳。查体 :消瘦、营养差 ,毛发干燥、稀少 ,易断、易脱落 ,面部红斑样色素沉着 ,眼睑略苍白 ,双目炯炯有神 ,     

Interstitial Lung Disease and Other Pulmonary Manifestations in Connective Tissue Diseases

Lung involvement in connective tissue diseases is associated with substantial morbidity and mortality, most commonly in the form of interstitial lung disease, and can occur in any of these disorders. Patterns of interstitial lung disease in patients with connective tissue disease are similar to those seen in idiopathic interstitial pneumonias, such as idiopathic pulmonary fibrosis. It may be difficult to distinguish between the 2 ailments, particularly when interstitial lung disease presents before extrapulmonary manifestations of the underlying connective tissue disease. There are important clinical implications in achieving this distinction. Given the complexities inherent in the management of these patients, a multidisciplinary evaluation is needed to optimize the diagnostic process and management strategies. The aim of this article was to summarize an approach to diagnosis and management based on the opinion of experts on this topic.     

结缔组织病合并肺动脉高压患者的右室功能:多普勒组织成像技术研究

目的采用多普勒组织成像技术分析结缔组织病（CTD）合并肺动脉高压（PAH）患者右室功能和各项指标之间的关系。方法34例CTD合并PAH患者以及32例无PAH的对照者进行超声心动图检查,评价右室大小和功能。同时采用多普勒组织成像（DTI）评价右室侧壁、室间隔和左室侧壁的应变曲线及三尖瓣环的运动速度。结果DTI结果显示与对照组相比,CTD合并PAH患者的右室应变峰值、三尖瓣环收缩速度和舒张早期速度显著降低,同时存在右室不同步。结论DTI技术可以反映CTD合并PAH患者的右室功能状况。     

Laboratory Tests for Diagnosing Connective Tissue Diseases

The author describes three most useful groups of laboratory tests for connective tissue disease — hemogram, acute phase reactants and immune factors. Since most of these tests are relatively non-specific, the most valuable assets for arriving at the correct diagnosis of a connective tissue disease are still a complete history, thorough physical examination and a good knowledge of the course of the disease. Newer laboratory tests can then serve as adjuncts in confirming the diagnosis or following the course of the disease.     

Studies of T- and B-Lymphocytes in Patients with Connective Tissue Diseases

Peripheral blood lymphocytes from normal subjects as well as patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and active tuberculosis were studied for the relative distribution of bone marrow-derived lymphocytes (B-cells) and thymic-derived T-cells. B-cells were identified by direct immunofluorescence of surface Ig markers; T-cells were studied using rabbit antisera to pooled human fetal thymocytes absorbed with chronic lymphatic leukemia lymphocytes as a source of B-cells. In normal subjects, the sum of percentages of peripheral blood lymphocytes staining for surface Ig (B-cells) plus the percentage of cells staining with the absorbed antithymocyte antiserum closely approximated 100%. The mean value for percent B-cells among 51 normals tested was 22.9%±7.1; mean T-cells value was 75.3±13.95%. T-cell-specific antiserum stained 18% of normal human bone marrow lymphocytes, 42.5% of lymphocytes from normal spleens, and 98% of cells obtained from thoracic duct drainage of patients with RA. Specificity of antihuman thymocyte antiserum appeared to depend on the use of living cells.     

SARS胸部影像学表现及分型

目的 探讨急性传染性非典型肺炎的影像特征与分型。方法 通过回顾性分析和部分病理对照的方法对105例传染性非典型肺炎的胸部X线片及CT片进行研究。结果 肺实质局部浸润占23．8％，肺实质广泛浸润占24．8％；肺间质局部浸润占11．4％；肺间质广泛浸润占18．1％；混合浸润占21．9％。结论 胸部X线片发现肺部浸润病灶是临床诊断急性传染性非典型肺炎的重要依据之一。根据肺部渗出病灶的类型可大致分为肺实质浸润、肺间质浸润、混合浸润三大类。结合流行病史或免疫学检查可与其他肺炎鉴别。     

Cyclophosphamide Induces More Chromosome Damage than Chlorambucil in Patients with Connective Tissue Diseases

The potential for damaging chromosomes of the powerful and widely-usedimmunosuppressive agent cyclophosphamide has been tested bymeasuring sister chromatid exchanges in blood lymphocytes ofpatients with connective tissue diseases. This agent inducesmore chromosome damage than chlorambucil emphasising the needfor sensitive means of predicting patients at particular riskof drug-induced malignant disease.