摘要
目的 探讨对结缔组织病 (CTD)患者肺间质病变 (ILD)进行早期、安全、有效且可量化的诊断方法。方法 对 93例CTD患者 ,其中 4 8例系统性红斑狼疮 (SLE)、18例皮肌炎 (DM)、2 1例系统性硬皮病 (PSS)、6例干燥综合征 (SS)进行了一氧化碳弥散功能检测 ,并与X线胸片、肺部高分辨率CT(HRCT)结果相比较 ;同时测定了 5 0名正常人的X线胸片和一氧化碳弥散功能作为对照。结果 X线胸片、肺部HRCT和一氧化碳弥散功能检测 (以一氧化碳弥散吸收率 <80 %为标准 )在SLE中检测到ILD的比率分别是 15 %、36 %和 4 2 % ;在DM中的比率分别是 17%、36 %和 39% ;在PSS中的比率分别是 38%、4 2 %和 5 2 % ;SS的比率分别是 33%、6 7%和 5 0 %。而正常人的X线胸片均正常 ,一氧化碳弥散吸收率均≥ 80 %。结论 X线胸片在检测CTD患者ILD中敏感性最低 ,而HRCT和一氧化碳弥散功能是检测CTD患者ILD的敏感方法。尤其是后者 ,具有敏感性高、不受X线照射、易被患者接受和对其损害程度进行量化等优点 ,既可作为早期了解CTD患者ILD的检测方法 ,又可通过一氧化碳弥散功能的改变对治疗效果进行评价。
Objective To evaluate the value of diffusing capacity of carbon monoxide (CO) as a sensitive and effective test for the diagnosis of early interstitial lung disease(ILD) associated with connective tissue disease (CTD).Methods Ninety three patients with CTD, which included 48 patients with systemic lupus erythematosus (SLE), 18 patients with dermatomyositis (DM), 21 patients with progressive systemic sclerosis (PSS), and 6 patients with sjogren′s syndrome (SS), were studied by chest radiography, HRCT and diffusion capacity of carbon monoxide. Fifty healthy individuals were included as the control group.Results Seven of the 48 (15%) patients with SLE, 3 of the 18(17%) with DM, 8 of the 21 (38%) with PSS, and 2 of the 6 (33%) with SS were found to have ILD by chest radiography. HRCT abnormalities for ILD were noted in 5/14 (36% )of the patients with SLE, 4/11 (36% )with DM, 5/12 (42% )with PSS, and 2/3 (67%) with SS. Alternation in D LCO was present in 20(42%) patients with SLE, 7(39%) with DM, 11(52%) with PSS and 3(50%) with SS. The means of D LCO were (81±26)% in SLE, (79±19)% in DM , (76±25)% in PSS and (76±11)% in SS, which were significantly different from that in the healthy controls [D LCO=(103±9)%] ( P <0.01).Conclusions For the diagnosis of ILD in CTD, chest radiography was less sensitive than HRCT and D LCO. D LCO, which is highly sensitive, without radioactivity and favorably accepted by patients, may be considered as the method of choice in the early diagnosis of ILD in patients with CTD.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2002年第7期396-398,共3页
Chinese Journal of Tuberculosis and Respiratory Diseases
关键词
结缔组织病
肺间质病变
一氧化碳弥散功能
Connective tissue disease
Interstitial lung disease
Diffusing capacity, carbon monoxide
