间质性肺疾病合并肺栓塞12例的临床特征分析

Clinical features of 12 cases of interstitial lung disease complicated by pulmonary embolism

目的探讨分析间质性肺疾病（ILD）合并肺栓塞（PE）患者的临床特征。方法收集2011年1月至2011年12月期间在广州呼吸疾病研究所住院治疗的12例ILD并发PE的患者为ILD合并PE组，并募集同期24例性别、年龄相匹配的PE患者作为对照，即单纯PE组，比较两组病例的身高、体质量、既往病史、近期制动或手术、吸烟、糖皮质激素使用等特征，咯血、胸痛、呼吸困难、心悸、下肢浮肿等症状，以及D二聚体、动脉血气分析、肺动脉收缩压、PE类型（大面积和非大面积）等实验室检查。结果与单纯PE组相比，ILD合并PE组糖皮质激素应用史（50．0％vs12．5％）、咳嗽（100．0％VS70．8％）、心悸（41．7％VS8．3％）比例更高，动脉血气分析提示PaO2下降更明显[（63．14±12．94）mmHgVS（73．05±14．67）mmHg]。两组在基础疾病、咯血、胸痛、呼吸困难、下肢浮肿、血常规、D二聚体、肺动脉收缩压及PE的类型差异无统计学意义，12例ILD合并PE的患者都为非大面积PE。结论ILD合并PE组患者糖皮质激素应用及咳嗽、心悸等症状发生率高，动脉血气PaOz下降更明显，对ILD合并PE可能有提示作用。

Objective To analysis the clinical features of patients with interstitial lung disease complicated by pulmonary embolism （ILD-PE）. Methods Twelve cases of ILD-PE and 24 cases of PE as the control group were recruited from January 2011 to December 2011 in the Guangzhou Institute of Respiratory Diseases. Height, body mass, past medical history, recent braking or operation, smoking, glucocorticoid use, symptoms such as hemoptysis, chest pain, dyspnea, heart palpitations, lower extremity edema, and D-dimer, arterial blood gas analysis, pulmonary artery systolic pressure, type of PE （large area and non massive） were compared between two groups. Results Compared with control group, the incidence of cough （100.0% vs 70.8%） , palpitations （41.7% vs 8.3%） , application of glucocorticoid （50.0% vs 12.5%） in ILI）-PE group was higher. There was no significant difference in underlying disease,hemoptysis, chest pain, dyspnea, lower extremity edema, D-dimer, pulmonary artery systolic pressure,and type of PE between two groups. All 12 cases of ILD-PE were non-massive PE. Conclusions In ILD-PE patients, the incidence of cough, palpitations,and glucocorticold use is higher, PaO2 significantly decreases,which suggests that ILD is complicated by PE.