结缔组织病肺间质病变的临床特点及治疗效果分析

目的探讨不同结缔组织病肺间质病变（CTD-ILD）的临床特点和治疗效果。方法分析82例CTD-ILD患者的临床特征及胸部高分辨CT（HRCT）特点并观察治疗后HRCT的变化。结果（1）SSc—ILD的发生率最高，为70．0％。其次为pSS—ILD、PM／DM-ILD、RA—ILD、SLE—ILD，系统性红斑狼疮继发的ILD（SLE—ILD）发病年龄（26．2±7．8）较其他CTD-ILD早（P〈0．05）。RA—ILD、SSc—ILD病程较长，pSS—ILD、SLE一[LD和PM—ILl）病程较短。RA．ILD出现活动后气促少见（P〈0．05）。pSS—ILD出现呼吸道症状（40％）和体征（50％）最多见。85．7％SSc-ILD出现雷诺现象，支持雷诺现象与ILD相关。（2）SLE—ILD以磨玻璃影多见，丽蜂窝状改变较少；pSS-ILD以蜂窝状改变和纵隔淋巴结肿大相对较多。（3）大部分患者治疗后肺部间质病变吸收好转（56．7％），其中88．2％SLE—ILD吸收好转，28．4％患者肺部病变处于静止，14．9％患者间质病变较前进展。结论CTD—ILD患者一旦确诊，应尽早用激素联合免疫抑制剂治疗。

Interstitial lung disease in patients with connective tissue diseases

Objective To investigate the prevalence and clinical characters of connective tissue diseasesinterstitial lung disease （CTD-lLD）. Methods Eight-two patients with CTD-ILD were studied. Every patients had radiography and high-resolution computed tomography （HRCT）. Results （ 1 ） ILD positive rate in SSc is 70. 0% ,more than other CTDs. SLE-ILD patients are yungest（26. 2 ± 7.8）. RA-ILD and SSc-ILD have longer course of disease than pSS-ILD, SLE-ILD and PM-ILD. RA-ILD espiratory symptoms are very light. 85.7% SSc-ILD accompany with Raynaud~ phenomenon. （2） Honey combing and mediastinal lymphadeneetasis are the most imagings on the HRCT of pSS-ILD. Ground glass opacity was commonly seen in SLE-ILD. （3） compared images of HRCT, 56. 7% cases responded to treatment, 28.4% cases had no change, and 14.9% cases grew worse. Conclusion Patients with CTD-ILD need to begin treatment once they are diagnosed.