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1、结缔组织病相关的肺间质病变临床特点分析周明韬(池州市人民医院肾脏风湿科,安徽池州247000)【摘要】目的：提高对结缔组织病相关的肺间质病变临床特点的认识。方法：冋顾分析12例结缔组织病合并肺间质病变患者的临床表现、影像学改变、治疗与转归。结果：12例患者类风湿关节炎5例，混合性结缔组织病2例，干燥综合征2例，系统性红斑狼疮1例，皮肌炎1例，多发性肌炎1例。呼吸系统症状表现为咳嗽咳痰、活动后胸闷气短；肺部体征以Velcro啰音为主；肺部高分辨CT(HRCT)检查表现为磨玻璃样影、条索状影、网状影、斑片状影、肺大泡和蜂窝样影,全胸片表现为条索状彩和斑片
2、状彩；1例干燥综合征和1例系统性红斑狼疮患者肺间质病变发现较早，经糖皮质激素和环磷酰胺治疗症状缓解，肺间质病变发现较晚者，经糖皮质激索和各种免疫抑制剂治疗,症状和影像学表现无明显改善，预后差。结论：结缔组织病相关的肺间质病变早期呼吸系统症状不明显，肺部HRCT检查有利于早期诊断，糖皮质激素和环磷酰胺早期治疗有利于改善病情和预后。［关键词］肺间质病变；结缔组织病；临床特点Analysisofclinicalcharacteristicsassociatedwithinterstitiallungdiseaseofconnectivetissuedise
3、aseZHOUMing-tao(DepartmentofNephrologyandRheumatology,ChizhouPeople，sHospital,Chizhou247000,China)IAbstract]0bjective:Toimprovetheunderstandingofclinicalcharacteristicsofconnectivetissuediseaseassociatedwithinterstitiallungdisease・Methods:Clinicalmanifestations,imagingcha.nges,
4、treatmentandprognosisin12patientswithconnectivetissuediseaseassociatedwithinterstitiallungdiseasewereretrospectiveanalyzed.Results:Therewere5casesofpatientswithrheumatoidarthritis,2casesofmixedconncctivctissuedisease,2casesofSjogren'ssyndrome,1caseofsystemiclupuserythematosus,1
5、caseofdermatomyositisand1caseofpolymyositisin12patients・Respiratorysymptomsincludedcough,expectorationandshortnessofbreathafteractivity;MainpulmonaryphysicalsignswereVelcrorales;pulmonaryhigh-resolutionCT(HRCT)examinationshowedground-glassopacities,cord-likeshadow,reticularopac
6、ities,patchyshadow,pulmonarybullaandhoneycomb-likeshadow;fullchestX-rayshowedstreakshadowandpatchyshadow;onecaseofSjogren'ssyndromeandonecaseofsystemiclupuserythematosuspatientswithinterstitiallungdiseasewerediscoveredearlierandtheirsymptomsdecreasedwithglucocorticoidsandcyclop
7、hosphamidetreatment・Patientswhosepulmonaryinterstitia.1lesionsfoundlater,withglucocorticoidsandimmunosuppressanttherapy,hadnoobviousimprovementofsymptomsandimagingfindings・Theirprognosiswerepoor.Conclusion:Earlysymptomsofrespiratorysystemwerenotobviousinpatientswithinterstitial
8、lungdiseaseofconnectivetissuedisease・PulmonaryHRCTexam
