结缔组织病伴间质性肺疾病的治疗研究

MANAGEMENT OF INTERSTITIAL LUNG DISEASES COMPLICATED BY CONNECTIVE TISSUE DISEASES

目的 对结缔组织病 (CTD)伴间质性肺疾病 (ILD)患者进行治疗研究。方法 13例CTD伴ILD患者治疗半年后复查。结果 12例患者血沉 (ESR)下降 ,肺功能、一氧化碳弥散量 (DLCO)、PO2 有明显改善 ,且P <0 .0 5。胸片检查 :1例毛玻璃样改变和 1例斑片网格状阴影基本消失。 1例网格状阴影形成蜂窝状影。HRCT检查 :9例毛玻璃样改变中 ,7例有改善 ,2例形成索条蜂窝样改变 ;2例胸膜下结节和 2例胸膜边缘不规则消失 ;3例小叶间隔增厚消失。其余的网状、索条、蜂窝状和肺大泡基本无改变。 1例SLE患者因合并肺部感染而死亡。结论 对急性ILD早期强的松或强的松加免疫抑制剂治疗 ,对慢性ILD可不予特别治疗。对ILD合并肺部感染者 ,要严格掌握激素用量 。

Objective\ In order to study the treatment of the connective tissue diseases (CTD)with complication the interstital lung diseases(ILD). Methods\ Thirteen non-smoking CTD with complication ILD patients were re-examined after 6 months treatment period. Results\ Treatment results revealed changed in ESR and pulmonary function tests(PFT), it had significantly different (P<0.05),and improved in chest X-ray examination in twelve patients. In nine patients of the grond-glass appearance of high-resolution computed tomography(HRCT), had obvious improved in seven patients and had changed the honeycombing appearance in two patients. Interlobular septal thickening of three patients and subpleural nodules of two patients and irregular pleural margins of two patients had obvious improved. Other appearance of HRCT revealed unchanged for and reticulation and honeycombing and emphysema.One SLE with compli\|cation ILD patient had died for combining pulmonary infection. Conclusion\ Acute ILD should been early treated with prednisone or prednisone and immunosuppressor. Clinical ILD were not been especially treated. The dose of prednisone were been strict mastered and synthesize treatment were been used for ILD with pulmonary infection.