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1、103例间质性肺疾病的临床特点分析研究生:张灿花导师:何元兵副教授摘要目的分析间质性肺疾病的临床特点、肺功能、血气分析、影像学检查及实验室检查结果,以期为间质性肺疾病(ILD)的临床诊断提供依据。方法回顾性分析我院2008年1月至2010年12月资料完整临床确诊的103例间质性肺疾病的临床资料。结果103例间质性肺疾病的病例中以特发性间质性肺疾病所占比例最多,其次为慢性阻塞性肺病(chronicobstructivepulmonarydisease,COPD)合并间质性肺疾病、结缔组织病合并间质性肺疾病,有吸烟史者40例。突出的临床表现
2、为干咳、进行性呼吸困难伴(或)喘息,特发性间质性肺疾病较继发性间质性肺疾病更易出现爆裂音、杵状指两组比较差异有统计学意义(P<0.05);影像学上,网格状改变特发性间质性肺疾病较继发性间质性肺疾病多,P<0.05;继发性间质性肺疾病较多出现胸膜受累P<0.05,特发性间质肺疾病多为限制性通气功能障碍及弥散功能障碍,继发性间质性肺疾病多为限制性通气功能障碍为主的混合性通气功能障碍。103例患者的血气分析结果示32例患者有低氧血症,28例患者有Ⅰ型呼吸衰竭,2例患者有Ⅱ型呼吸衰竭。特发性间质性肺病合并肺动脉高压者8例,占特发性间质性肺疾病的
3、15.69%,继发性间质性肺病合并肺动脉高压者27例,两组比较,继发性间质性肺病比特发性间质性肺病更易出现肺动脉高压,差别有统计学意义。结论根据患者临床症状、体征、肺功能、血气分析、影像学检查及实验室检查结果可初步临床诊断间质性肺疾病。关键词间质性肺疾病临床表现血气分析肺功能影像Clinicalanalysisof103patientswithinterstitiallungdiseasesPostgraduate:CanhuaZhangSupervisor:Prof.YuanbingHeassociateprofessorABSTRA
4、CTObjective:Toanalyzetheclinicalfeatures,Pulmonaryfunctiontest,bloodgasanaly-sis,radiography,laboratorytestsofthepatentswithinterstitiallungdiseases(ILD),TheaimofthisstudywastohelpusknowILDwell,anddiagnosisthemproperly.Methods:Atotalof103ILDpatientsfromJanuary2008toDecem
5、ber2010wereincludedinthisstudy.Theirclinicalsymptoms,physicalsigns,pulmonaryfunction,arterialbloodgasandcomputedtomographs(CT)orhighresolutioncomputedtom-ographs(HRCT)ofthechestwereanalyzedandcompared.Results:Among103patients,theratioofidiopathicInterstitiallungdisease(I
6、ILD)wasthehighest,followedbychronicobstructivepulmonarydisease(COPD),connectivetissuediseasescomplicatingILD.Mainsymptomsweredrycough,insidiousonsetofprogressivedyspneaorpant,cracksandfingerclubbingshowedmoresevereinidiopathicInterstitiallungdiseasethansecondaryinterstit
7、iallungdiseases(SILD),P<0.05.ThemostcommonRadiograghicfindingswerebibasilarreticularpatternsandshowedmoresevereinIILDgroupsthaninSILDgroups,P<0.05.ThepleuralinvolvementweremorecommoninSILDgroupsP<0.05.Themostcommonrestri-ctiveventilitorydisorderanddiffusingcapacityshowed
8、inIILD,ILDwasmainmixedventilationdisorders.36patientswithILDhadhypoxemia,28patientswithILDhadⅠrespi-rat