本文選題：結(jié)締組織病　切入點：肺間質(zhì)病變　出處：《中南大學學報(醫(yī)學版)》2017年08期 　論文類型：期刊論文

【摘要】：目的:分析結(jié)締組織病相關(guān)性肺間質(zhì)病變(connective tissue associated interstitial lung disease,CTD-ILD)的高分辨CT(high resolution computed tomography,HRCT)表現(xiàn)。方法:收集中南大學湘雅醫(yī)院2013年9月至2015年9月結(jié)締組織病患者127例,所有患者均經(jīng)臨床實驗室檢查或病理學檢查確診為結(jié)締組織病,且HRCT證實存在肺間質(zhì)病變,回顧性分析患者的肺部HRCT影像表現(xiàn)。結(jié)果:127例患者結(jié)締組織病分類包括類風濕關(guān)節(jié)炎36例(28.3%),皮肌炎及多肌炎34例(26.8%),系統(tǒng)性硬化癥31例(24.4%),干燥綜合征18例(14.2%),混合性結(jié)締組織病7例(5.5%),系統(tǒng)性紅斑狼瘡1例(0.8%)。根據(jù)HRCT表現(xiàn)分為非特異性間質(zhì)性肺炎(nonspecific interstitial pneumonia,NSIP)77例(60.6%),尋常型間質(zhì)性肺炎(usual interstitial pneumonia,UIP)46例(36.2%),淋巴細胞性間質(zhì)性肺炎(lymphocytic interstitial pneumonia,LIP)2例(1.6%),隱源性機化性肺炎(cryptogenic organizing pneumonia,COP)1例(0.8%),急性間質(zhì)性肺炎(acute interstitial pneumonia,AIP)1例(0.8%)。36例類風濕關(guān)節(jié)炎相關(guān)性肺間質(zhì)病變的HRCT表現(xiàn)為UIP(24例,66.7%)和NSIP(12例,33.3%)。34例皮肌炎及多肌炎相關(guān)性肺間質(zhì)病變的HRCT表現(xiàn)為NSIP(32例,94.1%),UIP和COP(各1例,各占2.9%)。31例系統(tǒng)性硬化癥相關(guān)性肺間質(zhì)病變的HRCT表現(xiàn)為NSIP(21例,67.8%)和UIP(9例,29.0%),LIP(1例,3.2%)。18例干燥綜合征相關(guān)性肺間質(zhì)病變的HRCT表現(xiàn)為NSIP(9例,50.0%),UIP(8例,44.4%)和LIP(1例,5.6%)。7例混合型CTDILD的HRCT表現(xiàn)為UIP(4例,57.1%)和NSIP(3例,42.9%)。系統(tǒng)性紅斑狼瘡僅見1例AIP。結(jié)論:不同類型CTD-ILD的HRCT表現(xiàn)具有相對獨特的特點。
[Abstract]:Objective: to analyze the high resolution CT(high resolution computed tomography-HRCTs of connective tissue associated interstitial lung disease (CTD-ILD). Methods: from September 2013 to September 2015, 127 patients with connective tissue disease (CTD-ILD) in Xiangya Hospital of Central South University were collected. All the patients were diagnosed as connective tissue disease by clinical laboratory or pathological examination, and the pulmonary interstitial disease was confirmed by HRCT. Results the classification of connective tissue disease included 36 cases of rheumatoid arthritis, 36 cases of rheumatoid arthritis, 34 cases of dermatomyositis and polymyositis, 31 cases of systemic sclerosis, 18 cases of Sjogren's syndrome, and 14 cases of mixed disease. 7 cases of connective tissue disease and 1 case of systemic lupus erythematosus were divided into nonspecific interstitial pneumonia, nonspecific interstitial pneumoniae, 77 cases with nonspecific interstitial pneumoniae, 46 cases with normal interstitial pneumoniae, 46 cases with UIPA, 2 cases with lymphocytic interstitial pneumonia, 2 cases with lymphocytic interstitial pneumoniae and 2 cases with cryptogenic interstitial pneumonia. One case of Cryptogenic organizing pneumoniae with acute interstitial pneumonia, one case of acute interstitial pneumoniae with acute interstitial pneumonia, one case with acute interstitial pneumonia, one case with acute interstitial pneumoniae, 36 cases with rheumatoid arthritis associated with pulmonary interstitial disease (UIP(24 case: 66.7am) and NSIP(12 case case case (33.33.34 cases of dermatomyositis and polymyositis associated pulmonary interstitial disease), the HRCT manifestation of acute interstitial pneumonia and polymyositis associated with pulmonary interstitial disease were as follows: 1 case: 0. 8%; 1 case of acute interstitial pneumonia; 1 case of acute interstitial disease; One case of NSIP(32 (1 case each) was treated with UIP and (1 case) with COP (1 case each). The HRCT manifestations of 31 cases of pulmonary interstitial disease associated with systemic sclerosis are NSIP(21 (67.8) and UIP(9 29.00.The HRCT manifestations of 18 cases of Sjogren syndrome associated pulmonary interstitial disease are NSIP(9 (50.0%) and LIP(1 (5.6%) and LIP(1 (5.6%). The HRCT manifestations of mixed CTDILD are as follows: 1 case of Sjogren's syndrome associated pulmonary interstitial disease (NSIP(9 case: 50. 0%) and 5. 6% of LIP(1 case of mixed CTDILD. UIP(4 (57.1%) and NSIP(3 (42.9%). Only one case of systemic lupus erythematosus was found. Conclusion: the HRCT features of different types of CTD-ILD are relatively unique.
【作者單位】： 中南大學湘雅醫(yī)院放射科;
【基金】：國家自然科學基金(81500001)~~
【分類號】：R563;R593.2;R816.41

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