CAJ | 학술논문

目的：观察结缔组织病致肺间质病变的临床表现特点、生理指标变化及干预效果。方法对我院2010年3月~2013年10月所收治103例结缔组织病致肺间质病变住院患者进行研究，观察患者临床表现并进行血气分析，结合实际情况予以相应治疗，观察干预结果。结果 CTD-ILD患者主要临床表现包括呼吸系统症状及全身症状两个方面，其中DM/PM主要症状以发热、呼吸困难为主，SLE以呼吸困难为主，RA为咳嗽，pSS以呼吸系统症状为主。所有患者中，咳嗽、呼吸困难、皮肤损害、发热等症状患者较多。103例患者中，36．9%血气分析结果正常，34．9%患者为低氧血症，23．3%为Ⅰ型呼吸衰竭，Ⅱ型呼吸衰竭患者较少，所占比例仅为4．9%。DM/PM、SLE、RA、pSS、SSc不同类型疾病血气分析结果存在较大差异。103例患者均应用激素或免疫抑制剂进行治疗，结合患者实际情况的不同，治疗方案包括泼尼松单独治疗、泼尼松联合环磷酰胺、泼尼松联合羟氯喹、泼尼松联合氟米特、泼尼松联合甲氨蝶呤等。其中94例患者各临床症状，明显好转，9例患者病情未得到明显控制，无死亡病例。结论 CTD-ILD临床表现以呼吸系统症状及全身症状两方面为主，患者易合并低氧血症，激素联合免疫抑制剂为目前最有效治疗方法，效果较好。
목적：관찰결체조직병치폐간질병변적림상표현특점、생리지표변화급간예효과。방법대아원2010년3월~2013년10월소수치103례결체조직병치폐간질병변주원환자진행연구，관찰환자림상표현병진행혈기분석，결합실제정황여이상응치료，관찰간예결과。결과 CTD-ILD환자주요림상표현포괄호흡계통증상급전신증상량개방면，기중DM/PM주요증상이발열、호흡곤난위주，SLE이호흡곤난위주，RA위해수，pSS이호흡계통증상위주。소유환자중，해수、호흡곤난、피부손해、발열등증상환자교다。103례환자중，36．9%혈기분석결과정상，34．9%환자위저양혈증，23．3%위Ⅰ형호흡쇠갈，Ⅱ형호흡쇠갈환자교소，소점비례부위4．9%。DM/PM、SLE、RA、pSS、SSc불동류형질병혈기분석결과존재교대차이。103례환자균응용격소혹면역억제제진행치료，결합환자실제정황적불동，치료방안포괄발니송단독치료、발니송연합배린선알、발니송연합간록규、발니송연합불미특、발니송연합갑안접령등。기중94례환자각림상증상，명현호전，9례환자병정미득도명현공제，무사망병례。결론 CTD-ILD림상표현이호흡계통증상급전신증상량방면위주，환자역합병저양혈증，격소연합면역억제제위목전최유효치료방법，효과교호。
Objective To observe the clinical performance characteristics, physiological changes and the effect of intervention of pulmonary interstitial disease by connective tissue disease. Meth-ods 103 cases of connective tissue disease induced interstitial lung disease patients in our hospi-tal in March 2010~October 2013 were studied, observation of patients with clinical manifestation and analyzed blood gas, combined with the actual situation to corresponding treatment, observed the result of intervention. Results In CTD-ILD patients, the main clinical manifestations included two aspects of respiratory symptoms and systemic symptoms, including the main symptoms of DM/PM with fever, shortness of breath, SLE to shortness of breath, RA was cough, pSS with respira-tory symptoms. All patients mostly with symptoms in patients like cough, breathe in difficulty, skin lesions, fever and other. In 103 patients, 37.9% had normal blood gas results, 34% patients had hypoxemia, 23.2% as type I respiratory failure, fewer patients with type II respiratory failure, the proportion was only 4.9%.There was great variation of DM/PM, SLE, RA, pSS, SSc and blood gas analysis results of different types of diseases.Conclusions The clinical manifestations of CTD-ILD in two aspects of respiratory symptoms and systemic symptoms, patients easily complicated with hypoxemia, hormone combined with immunosuppressive is the most effective method of treat-ment, the effect is better.