Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients w...Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients with different CTDs were recruited and underwent lung HRCT and PFT. Eerythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum ferritin (SF), anti-SSA, and so on were tested. Based on HRCT, a patient was classified into ILD group (CTD+ILD) or non-ILD group (CTD-ILD). HRCT, PFT, and laboratory markers were compared according to CTDs and CTD-associated ILDs. Results. The incidences of ILD were 79.6%, 82.0%, 89.7%, and 97.1% respectively for Rheumatoid arthritis (RA), primary Sjogren’s symptom (pSS), dermatomyositis/polymyositis (DM/PM), and systemic sclerosis (SSc) groups. RA and pSS patients exhibited more nodules, patching, ground-glass opacity, and cord shadow foci in HRCT, DM/PM and SSc patients exhibited more reticular opacity and honeycombing foci. RA and pSS patients exhibited more obstructive ventilatory disorder, small airway dysfunction and emphysema in PFT, and DM/PM and SSc patients exhibited more restrictive ventilatory disorder, mixed ventilatory disorder. ESR, CRP and SF were significantly higher in total CTD+ILD group than in total CTD-ILD group (P = 0.047, 0.006, 0.004, respectively), and higher in different CTD+ ILD groups than in comparable CTD-ILD groups (P = 0.049, 0.048, and 0.023, pSS+ILD, SSc+ILD and RA+ILD compared to pSS-ILD, SSc-ILD and RA-ILD, respectively for ESR, CRP, SF). The positive rate of anti-SSA was significantly higher in DM/PM+ILD group than in DM/PM-ILD group (P = 0.025). Conclusions. The manifestations and incidences of ILDs differ among different CTDs in HRCT and PFT, and inflammation and anti-SSA are positively correlated with ILDs in different CTDs, which provide important evidences for judging disease condition and prognosis.展开更多
Diabetes mellitus (DM) is a chronic metabolic disease and its prevalence has beensteadily increasing all over the world. DM and its associated micro andmacrovascular complications result in significant morbidity and m...Diabetes mellitus (DM) is a chronic metabolic disease and its prevalence has beensteadily increasing all over the world. DM and its associated micro andmacrovascular complications result in significant morbidity and mortality. Themicrovascular complications are usually manifested as retinopathy, neuropathy,nephropathy and macrovascular complications generally affect the cardiovascularsystem. In addition to these complications, DM also affects the lungs because of itsrich vascularity and abundance in connective tissue (collagen and elastin). DMhas been found to cause microvascular complications and proliferation ofextracellular connective tissue in the lungs, leading to decline in lung function in arestrictive pattern. Interstitial lung disease (ILD) includes a diverse group ofdisease conditions characterized by different degrees of inflammation and fibrosisin the pulmonary parenchyma. Idiopathic pulmonary fibrosis (IPF) is one of thecommon type of idiopathic interstitial pneumonia with a high mortality rate. IPFis characterized by chronic progressive fibrosis leading to progressive respiratoryfailure. In this review we focus on lung as the target organ in DM and theassociation of DM and ILD with special emphasis on IPF.展开更多
The COPD Assessment Test was recently developed to assess health status in patients with COPD. However, little was known about its application to patients with interstitial lung disease, so we examined the relationshi...The COPD Assessment Test was recently developed to assess health status in patients with COPD. However, little was known about its application to patients with interstitial lung disease, so we examined the relationship between the COPD Assessment Test score and respiratory impairment including the clinical picture in subjects with interstitial lung disease. Data were collected retrospectively from 52 consecutive subjects with interstitial lung disease on admission to our facility. All subjects completed the COPD Assessment Test, in which a higher score represented a worse health status. They were also assessed by pulmonary function test, SpO2 during 6-min walk test, and arterial blood gases. The COPD Assessment Test score was negatively correlated with the percentage of predicted forced vital capacity, forced expiratory volume in 1 second, total lung capacity, diffusion capacity of the lung for carbon monoxide, and PaO2 (p = 0.0005, 0.005, 0.0002, 0.0005, and 0.002, respectively). Breathlessness was detected as the high scoring item, while phlegm and sleep were the last affected items. The COPD Assessment Test score was higher in subjects with oxygen desaturation in SpO2 (≥4%) during 6-min walk test (p = 0.0001) and in subjects on home oxygen therapy (p = 0.0007). More than 75% of subjects with oxygen desaturation during walking were classified into a medium or severer impact level of the COPD Assessment Test score, and subjects on home oxygen therapy were classified into a high or severer impact level. PaCO2 in room air and SpO2 at rest did not correlate with the COPD Assessment Test score. The reliability of items in the COPD Assessment Test was 0.87 by Cronbach’s α coefficient. Our results suggest that the COPD Assessment Test may be a candidate for evaluating the health status and impact of disease on patients with interstitial lung disease.展开更多
文摘Objective. To study the difference of interstitial lung diseases (ILDs) in high-resolution computerized tomography and pulmonary function test among different connective tissue diseases (CTDs). Methods. 209 patients with different CTDs were recruited and underwent lung HRCT and PFT. Eerythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum ferritin (SF), anti-SSA, and so on were tested. Based on HRCT, a patient was classified into ILD group (CTD+ILD) or non-ILD group (CTD-ILD). HRCT, PFT, and laboratory markers were compared according to CTDs and CTD-associated ILDs. Results. The incidences of ILD were 79.6%, 82.0%, 89.7%, and 97.1% respectively for Rheumatoid arthritis (RA), primary Sjogren’s symptom (pSS), dermatomyositis/polymyositis (DM/PM), and systemic sclerosis (SSc) groups. RA and pSS patients exhibited more nodules, patching, ground-glass opacity, and cord shadow foci in HRCT, DM/PM and SSc patients exhibited more reticular opacity and honeycombing foci. RA and pSS patients exhibited more obstructive ventilatory disorder, small airway dysfunction and emphysema in PFT, and DM/PM and SSc patients exhibited more restrictive ventilatory disorder, mixed ventilatory disorder. ESR, CRP and SF were significantly higher in total CTD+ILD group than in total CTD-ILD group (P = 0.047, 0.006, 0.004, respectively), and higher in different CTD+ ILD groups than in comparable CTD-ILD groups (P = 0.049, 0.048, and 0.023, pSS+ILD, SSc+ILD and RA+ILD compared to pSS-ILD, SSc-ILD and RA-ILD, respectively for ESR, CRP, SF). The positive rate of anti-SSA was significantly higher in DM/PM+ILD group than in DM/PM-ILD group (P = 0.025). Conclusions. The manifestations and incidences of ILDs differ among different CTDs in HRCT and PFT, and inflammation and anti-SSA are positively correlated with ILDs in different CTDs, which provide important evidences for judging disease condition and prognosis.
文摘Diabetes mellitus (DM) is a chronic metabolic disease and its prevalence has beensteadily increasing all over the world. DM and its associated micro andmacrovascular complications result in significant morbidity and mortality. Themicrovascular complications are usually manifested as retinopathy, neuropathy,nephropathy and macrovascular complications generally affect the cardiovascularsystem. In addition to these complications, DM also affects the lungs because of itsrich vascularity and abundance in connective tissue (collagen and elastin). DMhas been found to cause microvascular complications and proliferation ofextracellular connective tissue in the lungs, leading to decline in lung function in arestrictive pattern. Interstitial lung disease (ILD) includes a diverse group ofdisease conditions characterized by different degrees of inflammation and fibrosisin the pulmonary parenchyma. Idiopathic pulmonary fibrosis (IPF) is one of thecommon type of idiopathic interstitial pneumonia with a high mortality rate. IPFis characterized by chronic progressive fibrosis leading to progressive respiratoryfailure. In this review we focus on lung as the target organ in DM and theassociation of DM and ILD with special emphasis on IPF.
文摘The COPD Assessment Test was recently developed to assess health status in patients with COPD. However, little was known about its application to patients with interstitial lung disease, so we examined the relationship between the COPD Assessment Test score and respiratory impairment including the clinical picture in subjects with interstitial lung disease. Data were collected retrospectively from 52 consecutive subjects with interstitial lung disease on admission to our facility. All subjects completed the COPD Assessment Test, in which a higher score represented a worse health status. They were also assessed by pulmonary function test, SpO2 during 6-min walk test, and arterial blood gases. The COPD Assessment Test score was negatively correlated with the percentage of predicted forced vital capacity, forced expiratory volume in 1 second, total lung capacity, diffusion capacity of the lung for carbon monoxide, and PaO2 (p = 0.0005, 0.005, 0.0002, 0.0005, and 0.002, respectively). Breathlessness was detected as the high scoring item, while phlegm and sleep were the last affected items. The COPD Assessment Test score was higher in subjects with oxygen desaturation in SpO2 (≥4%) during 6-min walk test (p = 0.0001) and in subjects on home oxygen therapy (p = 0.0007). More than 75% of subjects with oxygen desaturation during walking were classified into a medium or severer impact level of the COPD Assessment Test score, and subjects on home oxygen therapy were classified into a high or severer impact level. PaCO2 in room air and SpO2 at rest did not correlate with the COPD Assessment Test score. The reliability of items in the COPD Assessment Test was 0.87 by Cronbach’s α coefficient. Our results suggest that the COPD Assessment Test may be a candidate for evaluating the health status and impact of disease on patients with interstitial lung disease.
