特发性非特异性间质性肺炎与结缔组织病相关性非特异性间质性肺炎的临床及HRCT比较

发布时间：2018-02-26 13:11

本文关键词： 特发性非特异性间质性肺炎结缔组织病相关性非特异性间质性肺炎临床表现肺功能测试 HRCT　出处：《实用医学杂志》2017年15期 　论文类型：期刊论文

【摘要】：目的探讨特发性非特异性间质性肺炎(INSIP)与结缔组织病相关性非特异性间质性肺炎(CTD-NSIP)的临床和胸部HRCT的不同特点。方法回顾性分析本院近年经临床-病理-影像多学科讨论诊断的73例NSIP患者资料,其中52例为INSIP组,21例为CTD-NSIP组,对两组的临床表现、肺功能测试及胸部HRCT征象进行对比研究。结果 CTD-NSIP组的原发病多为皮肌炎/多发性肌炎、类风湿关节炎、干燥综合征;平均发病年龄CTD-NSIP组[(47.14±9.24)岁]低于INSIP组[(59.09±11.20)岁],差异有统计学意义(P0.01);INSIP组出现咳痰比例较高,差异具有统计学意义(P=0.02);CTD-NSIP组出现口干/眼干(P=0.021)、关节痛(P=0.007)、皮疹(P=0.001)明显高于INSIP组,差异具有统计学意义;两组肺功能损害均以限制性通气功能障碍伴弥散功能下降为主,组间比较差异无统计学意义(P0.05);两组HRCT征象中,CTD-NSIP组出现胸膜下垂直线比例小于INSIP组(P=0.005),而出现实变影(P=0.049)、胸膜下线(P=0.004)、胸腔积液(P=0.022)以及食管扩张(P=0.021)比例高于INSIP组,差异具有统计学意义。结论熟悉INSIP和CTD-NSIP在临床及HRCT上相对特征性的表现,有助于两者的鉴别诊断。
[Abstract]:Objective to investigate the clinical and thoracic HRCT features of idiopathic nonspecific interstitial pneumonia (INSIP) and connective tissue disease associated nonspecific interstitial pneumonia (CTD-NSIPP). The clinical data of 73 patients with NSIP were discussed. Among them, 52 cases were INSIP group 21 cases were CTD-NSIP group. The clinical manifestation, pulmonary function test and chest HRCT sign of the two groups were compared. Results the primary diseases of CTD-NSIP group were dermatomyositis / polymyositis, rheumatoid arthritis and Sjogren's syndrome. The average age of onset in CTD-NSIP group [47.14 卤9.24] was lower than that in INSIP group [59.09 卤11.20 years]. The difference was statistically significant (P 0.01). The rate of expectoration in CTD-NSIP group was higher than that in INSIP group. The difference was statistically significant. The difference was statistically significant, the pulmonary function damage in the two groups was mainly restricted ventilation dysfunction accompanied by the decrease of diffusive function. There was no significant difference between the two groups (P 0.05), and the ratio of vertical line under pleura in CTD-NSIP group was lower than that in INSIP group (P 0.049). The proportion of subpleural effusion, pleural effusion and esophageal dilatation (P0.021) was higher than that in INSIP group. Conclusion it is helpful to know the clinical and HRCT features of INSIP and CTD-NSIP.
【作者单位】：广州医科大学附属第一医院放射科;广州医科大学附属第一医院呼吸科;
【基金】：国家卫计委行业专项基金项目资助项目(编号:201402013)
【分类号】：R563.1;R593.2;R816.41

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