结缔组织病相关性间质性肺炎的高分辨率CT比较研究

Comparation of HRCT in connective tissue disease associated interstitial pneumonia

目的明确结缔组织病(CTD)相关性间质性肺炎(IP)的高分辨率CT(HRCT)表现特点。方法回顾性收集2013年1月至2018年7月武警特色医学中心收治的76例CTD-IP患者HRCT资料。采用χ~2检验、非参数检验和二元Logistic回归分析。结果类风湿性关节炎(RA)组:蜂窝(63.2%)和牵拉性支气管扩张(84.2%)最常见;牵拉性支气管扩张是RA的重要预测因素;普通型间质性肺炎(UIP)是最常见表现型。皮肌炎/多发性肌炎(PM/DM)组:实变(42.9%)最常见;机化性肺炎是最常见表现型,而UIP少见。系统性红斑狼疮组:牵拉性支气管扩张少见。系统性硬化组:食管扩张多见(77.8%)。原发干燥综合征组:蜂窝少见(16.7%)。以蜂窝为主要表现的CTD中,RA最多见,蜂窝范围评分(1.2±1.2)分;以实变为主要表现的CTD中,PM/DM最多见,实变范围评分(0.7±1.0)分。结论各CTD-IP的HRCT表现存在一定的特征性。

Objective To identify characteristic high-resolution computed tomography(HRCT) findings for connective tissue disease(CTD) associated interstitial pneumonia(IP). Methods The HRCT findings of 76 patients with CTD-IP were evaluated, the abnormalities were compared among CTD-IP patients using χ2 test, nonparametric test, and binary logistic regression analysis. Results In rheumatoid arthritis associated IP(RA-IP), traction bronchiectasis was identified as the significant indicator based on binary logistic regression analyses. Traction bronchiectasis and honeycombing was identified as the most frequent finding based on χ~2 test. In polymyositis/dermatomyositis associated IP(PM/DM-IP), consolidation was identified as the most frequent findings based on χ~2 test, which reflected the higher frequency of the pathological organising pneumonia patterns. In systemic lupus erythematosus associated IP, traction bronchiectasis was identified as the least frequent findings based on χ~2 test. In systemic sclerosis associated IP, esophageal dilatation was the most extensive based on Kruskale-Wallis test. In primary Sjogren’s syndrome associated IP,honeycombing was identified as the least frequent findings based on χ~2 test. RA-IP was identified as the most frequent among CTD-IP which characterized as the predominance of honeycombing;PM/DM-IP was identified as the most frequent among CTD which characterized as the predominance of consolidation. Conclusion Several characteristic HRCT findings are identified in CTD-IP patients which are helpful for estimating underlying CTD.