206例结缔组织病肺部病变高分辨率CT分析

High Resolution Computed Tomography for the Evaluation of Lung Involvement in 206 Patients with Connective Tissue Diseases

目的:提高结缔组织病(CTD)肺部病变的早期诊断,评价高分辨率CT(HRCT)对结缔组织病患者肺、胸膜病变早期诊断的价值。方法:回顾性分析2002年1月至2006年3月在我院住院的CTD患者,共206例,其中包括系统性红斑狼疮(SLE)81例,系统性硬化(SS)32例,原发性干燥综合征(pSS)40例,多发性肌炎(PM)和皮肌炎(DM)26例,混合性结缔组织病(MCTD)27例。对所有患者的胸部进行HRCT扫描,并与普通X线平片进行对比,部分患者半年后重复肺部HRCT及普通平片检查。结果:普通胸片检出肺、胸膜异常者71例(34.47%),而肺部HRCT发现异常者共134例(65.05%),两者相比,P<0.01。重复HRCT及平片检查的39例患者中,HRCT发现有18例肺部症状好转(46.15%),而普通胸片只有7例好转(17.95%),两者相比,P<0.01。结论:HRCT对CTD患者肺、胸膜病变较普通X线具有更高的敏感性,能早期发现肺、胸膜的细微病变,同时也对CTD患者肺、胸膜病变药物疗效评价提供一定的帮助。

Objective： To evaluate the early diagnostic value of high resolution computed tomography （ HRCT） in detecting lung involvement in patients with connective tissue diseases （ CTD）. Method： A total of 206 CTD in -patients from Jan. 2002 to Mar. 2006 in our department were investigated with HRCT and pain chest radiography retrospectively. The part was investigated again after 6 months. Result：The percent- age of positive by HRCT is higher than by pain chest radiography （65.05% vs 34.47%, P 〈 0.01 ）. Con clusion：The results show the sensibility of lung involvement diagnosed by HRCT is higher than that by pain chest radiography. HRCT can find out the early and mild change of lung in CTD patients.