几种弥漫性结缔组织病肺间质病变的影像分析

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1、•临床研究•几种弥漫性结缔组织病肺间质病变的影像分析张晓林莉崔广恒【摘要】目的『解纭弥漫杵结缔组织病相关的肺间质病变（CTDJ1.D）的发生率、彬像学待征及氏与病种和临床指标的相关杵“方法回顾分析我院儿种弥漫性结缔组织病患再（共412例）资料,X线胸片检代或冇肺部临床症状患咅作胸部高分辨CT（HRCT）进•步检代确诊/解III）在不同弥漫件CTD中的发生率，对比X线与HRCT的差井，统计常用CT分类在本组疾病中的分布比例，探讨CT分类勺不同病种或临床转征之间的关系,结果4：412例弥漫性结缔组织病中，HRCT诊断的山【）共40例，总发生率为9.7%,氏中皮肌炎

2、/多肌炎为25%•硬皮病为23.8%.原发性十燥综介征为9.6%,系统件红斑狼疮为6.3%。胸片与CT符合率40%.W片谋诊漏诊率60%。H.DCT分类以两种病变共存嚴多见，其中E玻璃样变占40.1%,实变影32.8%,网格彬16.4%.蜂窝状彩9.8%。呼吸逍症状和补体C3.C4水平巾毛玻璃样变组及实变彬组;C反应®n（CHP）水平在峥窝状影和实变影组较其他对照组明显高，它们之间烙异灯统计学意义（”<0.05）。结论HRCT发现CTO-ILI）的敏感性及准确性明皑优于X线，Jt中以毛玻璃及实变影最多见;影像学改变与呼吸道症状及炎症指标右•-淀关系，尽早进行H

3、RCT的检杳有助ILI）的早期诊断及预后判断。【关键词】肺间质病变；结缔组织疾構；高分辨CTRadiologicalevaluationofinterstitiallungdiseaseindiffuseconnectivetissuediseasesZHANGXi(u)UNLi.CUIGuangcheng,departmentofRheumatology.GuangdongProvincialPeople'sHospital.Giiringzhou510080.ChinaCorrespondingauthorZHANGXiao.Email:xiaozhan

4、g640^>sohu.com[Abstract]ObjectiveToinvestigatetheprevalence,radiologicalfeaturesandtheassotuationbetweenHRCTchangesanddifferentdiseasesorclinicalfeaturesininterstitiallungdisease(11」))causedbydiffuseconnectivetissuediseases(CTD).MethodsRetrospectiveanalysiswasperformedbasedonthemedi

5、calrecordsof412in-patientswiththediagnosisofdiffuseconnectivetissuediseasesfromJune2003toJune2005inourhospital.268caseswereSLE.83caseswereSS,40caseswereDM/PM.21caseswereSSc.AllpatientshadchestX-rayandthesuspectedcaseshadHRCTexam.ThedistributionofILDamongdifferentdiffuseCTD,theappear

6、ancebetweenX-rayandHRCTappearanceswerecompared・ThecorrelationamongHRCTappearance,differentdiseasesandclinicalfeatureswasstudied・Results①Inthe412casesofCTD,ILDdetectedbyHRCTwas9.7%(40caseintotal)3-9%byX*ray.Amongthe40cases,DM/PMhadthehighestrateofILD(25%),23.8%inSS.9.6%inSSand6.3%in

7、S1E②TheconsensusratebetweenHRCTandX-raywas40%・Therateofmis-diagnosisofILDwas60%byX-ray.③ThechangesofinterstitialinvolvementdetectedbyHRCTwere:groundglasschange(41.0%),consolidation(32.8%),reticularchange(16.4%)andhoneycombchange(9.8%).Theconcomitantpresenceoftwooftheabovechangeswe

8、reverycommon.④Morel