摘要
目的探讨短期强化治疗后风湿病肺部病变的影像学改变。方法分析了43例6种风湿病肺部病变患者的临床及肺部影像学特点及对大剂量激素联合免疫抑制剂治疗后的中短期效果。结果 6种风湿病分别为:类风湿关节炎(RA)8例、系统性红斑狼疮(SLE)7例、原发性干燥综合征(pSS)7例、皮肌炎(DM)8例、坏死性肉芽肿性血管炎(NGV)7例、P-ANCA相关血管炎6例。所有患者均有不同程度的肺部影像学改变,以SLE肺部损害类型最多。半数以上患者有肺部症状。仅有1/5以此而就诊;肺部影像学改变多种多样,以实变影和间质改变最多见,各占46.5%;肺部毛玻璃影、胸腔积液、实变影、轻中度肺动脉高压的治疗有效率分别为100%、89.5%和80%,而肺间质改变的有效率仅有10%;3例分别死于SLE和Jo-1综合征;23例(54.8%)病情稳定达1年以上。结论早期轻度风湿性肺部改变对治疗反应敏感;选择适当病例予以积极治疗可使大多数患者病情好转或稳定。
Objective To investigate clinical and image feature of pulmonary involvement secondary to connective tissue disease （CTD） and the response to aggressive treatment. Method Clinical and image feature of 43 cases of 6 kinds of CTD with pulmonary involvement and response to treatment of pulse steroids and immunesuppressive agents was analyse. Results 6 kinds of CTD are as following ： 8 case of RA ; 7 case of SLE ; 7 case of pSS ; 8 case of DM ; 7 case of NGV ; 6 case of P-ANCA-related vasculitis; Diversity of image pattern in HRCT was seen and diffused interstitial change and irregular solid mass are the most, 46.5% for each; 58.1% with symptom of cough, short of breath, hemoptosis, etc. Only 1/5 of the patients see doctor as first onset ; Appearance as ground-glass opacity and hydrothorax ; solid mass, moderate pulmonary hypertention are response well to the treatment. Only 10% of diffused interstial changes showed response. 3 cases died shortly for disease deterioration. 54.8% cases was stable for at least 1 year; Conclusion The disease in early and mild stage is sensitive to the treatment. Aggressive treatment in well sellected cases could be benefit to most of the patients.
出处
《中国医刊》
CAS
2011年第1期39-42,共4页
Chinese Journal of Medicine
关键词
风湿病
肺部病变
治疗
Rheumatic disease
Pulmonary involvement
Treatment
