重庆市五家教学医院收治弥漫性肺间质疾病的回顾性分析

Retrospective analysis of diffuse interstitial lung disease in 5 teaching hospitals in Chongqing

目的分析重庆市弥漫性间质性肺疾病（DILD）住院患者的临床特征。方法收集2002-2006年重庆市5家教学医院收治住院的DILD病例资料，统计分析DILD住院患者占呼吸内科、全院住院患者的构成比，以及各临床表现、肺功能、血气分析、病理学等检查项目结果。结果重庆地区DILD住院患者男女比例约为1.83：1，平均年龄（61.65±13.31）岁。2002年DILD住院患者占呼吸科住院人数的2.83％o，占全院住院人数0．30‰，2006年分别为8.29‰和0.48‰。影像学以网格状改变为主的占62．2％，以毛玻璃改变为主的占11．3％，伴有蜂窝样改变的占24．5％。47．55％为限制性通气功能障碍，51．05％为混合性通气功能障碍。大多数患者存在低氧血症，动脉血PaO2为（71±25.2）mmHg。病理学检查以普通型间质性肺炎最为多见，81．82％的患者通过病理学检查资料也不能明确分类。结论DILD住院患者占呼吸科和医院住院患者构成比均呈上升趋势。确诊需要有经验的临床、放射和病理科医生共同参与。

Objective To investigate the constituent ratio and clinical features of diffuse interstitial lung disease （DILD） in Chongqing city. Methods Data was collected from all patients diagnosed as DILD in five comprehensive teaching hospitals in Chongqing from 2002 to 2006. The disease constituent ratio of DILD in the respiratory department or in the whole hospital was analysised. Meanwhile the clinical manifestation and the laboratory examination such as lung function and biopsy were also analysised. Results Mean age of DILD patients is （61.65±13.31 ） years with a ratio male to female of 1.83. The constituent ratio of DILD were 2.83‰, in respiratory department and 0.30‰ in hospital in 2002, and increased to 8.29‰ and 0.48‰ respectively in 2006. Graticule （62.20% ） and honeycombing （24.50% ） were predominant imaging manifestations. 47.55% patients had restrictive lung function impairment, and 51.05% had mixed lung function impairment. Pathologic examination revealed UIP as the most common type, however, 81.82% cases could not be classified to any category pathologically. Conclusions The prevalence of DILD increased progressively from 2002 to 2006. A definite diagnosis of DILD demands cooperation of physicians, radiologists and pathologists.