The Clinical Analysis Of Diffuse Lung Disease

Objective:To improve the cognition of the diagnosis, therapy and management of diffuse lung disease by investigating and summarizing its clinical features and therapeutic effects.Methods:Retrospective analysis was conducted on 53 cases of DLD according to the clinical features, chest X-ray, chest CT scan, lung function examinations, arterial blood gas analysis, other laboratory examinations, bronchoalveolar lavage, lung biopsy and the reoponse to treatment.Results:The 53 DLD patients,28 male and 25 female , had an average age of 52.3±13.4 years. 42(79.2%)out of 53 cases had cough, 39(73.6%) cases had an insidious onset of progressive dyspnea, 25(47.2%) had expectoration.18(34.0%) had Velcro rale and 5(9.4%)had finger clubbing. Velcro rale and finger clubbing were distributed on CTD pulmonary infiltration. All of the cases had the chest CT, exhibit diffuse nodular, glassy, reticular, stripe and alveolate lesious, and so on. 34 patients taken the lung function examination, 22(64.7%)had restrictive ventilation dysfunction, 25(73.9%)had diffuse disorder. Arterial blood gas analysis of 45 cases indicated 32(71.1%)had hypoxemia, 16(30.2%)had hyperventilation, 2 had CO₂ retention. 10 cases had lung biopsy: 2 cases by percutaneous CT guided biopsy of the lung; 4 cases by video-assisted thoracoscope, 4 cases by open lung biopsy. In addition, according to the clinical features, 38 cases were etiology known DLD. 10 cases of etiology known DLD were CTD pulmonary infiltration and 18 cases were infectious diseases, 10 cases were the other etiology known DLD. Etiology uncertain DLD had 15 cases, 11 cases were IPF of the total. After the combined treatment, 39 cases felt relief in clinical symptom during the hospitalization, but there are little changes in image. 4 patients were died.Conclusion:(1)DLD most often occurs in middle-age persons and shows no significant difference in sexuality.(2) DLD is a disease spectrum that including many lung diseases. cough, progressive dyspnea are the main symptoms. Velcro rale is the characteristic sign of IPF and CTD pulmonary infiltration.(3)The chest HRCT is a very important noninvasive examination on the diagnosis of ILD, especially for IPF. In the typical case, we can diagnose the IPF by the typical clinical features.(4)The lung biopsy is the golden criteria of diagnosis of DLD. According to the clinical features, we prior to transbronchial lung biopsy and percutaneous CT guided biopsy of the lung. Excluding typical IPF, the diagnosis of the other idiopathic interstitial pneumonia should need to perform the video-assisted thoracoscope or open lung biopsy.(5)Most of DLD were etiology known, the major of which were CTD pulmonary infiltration and infectious diseases. Less were etiology known, most of which were IIPs.(6)At present, we often use corticosteroids to treat IPF.(7)Corticosteroids is an effective treatment of sarcoidosis.