65例老年间质性肺疾病临床特征分析

Clinical characteristics analysis of 65 patients with the elderly interstitial lung diseases

目的探讨我院和市东医院老年患者间质性肺疾病（ILDs）的临床特点,以提高对ILDs的认识,加强对ILDs病因和基础疾病的分析,更好地治疗ILDs患者。方法对我院和市东医院自2008年9月~2010年12月临床诊断为ILDs的病例进行回顾性分析,对比分析其病程、症状、体征及影像学（胸片、胸部高分辨CT或HRCT）、肺功能及血气分析结果,从中发现共性及各自的特点。结果 （1）65例老年ILDs患者中,特发性肺间质纤维化（IPF）发病率最高（43.08%）,其余发病率较多的依次为：结缔组织病、慢性阻塞性肺气肿（COPD）、肺癌合并ILDs和充血性心力衰竭,分别占21.54%、12.31%、9.23%和7.69%。（2）不同病因的ILDs老年患者有ILDs的共同表现,但其临床症状、体征、影像学表现和肺功能等方面又有各自的特点。结论认识ILDs的共性和个性对ILDs的病因诊断、针对性治疗及判断疾病进展和预后具有重要意义。

Objective To discuss the clinical characteristics of the elderly interstitial lung diseases（ILDs） in our hospital and Shidong Hospital.This may help us know ILDs well,search their etiological factors,and treat them properly.Methods A total of 65 ILD patients in the past 27 months were included in this study.Their clinical courses,symptoms,physical signs,chest radiography features,computed tomographs（CT） or high resolution computed tomographs（HRCT） of the chest,pulmonary function,and arterial blood gas were analyzed and compared,so discovered general character and separately characteristic.Results（1） Among 65 patients,the ratio of idiopathic pulmonary fibrosis（IPF） was the highest（43.08%）,followed by connective tissue diseases,chronic obstructive pulmonary disease（COPD）,lung cancer complicating ILD and congestive heart failure,with rations of 21.54%,12.31%,9.23% and 7.69%.（2） ILD patients with different etiological factors had similar clinical manifestations,but showed some peculiar characteristics in symptoms,physical signs,radiological findings,and pulmonary functional test results.Conclusions Knowing the generality and particularity of ILDs is important for etiological diagnosis,proper treatment and predicting procession and long-term survival.