Clinical Analysis Of 83 Cases Interstitial Lung Disease Due To Connective Tissue Disease

Objective: Connective tissue disease (CTD) is a group of autoimmune diseases, involving multiple system and multiple viscera, especially the lungs presented interstitial lung disease. Interstitial Lung Disease complicated by Connective Tissue Disease (CTD-ILD) has high level of incidence and mortality, and generally it is not early stage when diagnosed due to lack of characteristic symptoms and signs, then we get poor outcomes. This paper summarizes the clinical characteristics of interstitial lung disease in patients diagnosed recently, which designed to improve early diagnosis, early treatment for the purpose of well outcomes involved prognosis and life condition.Methods: This paper retrospectively analysis 464 cases of hospitalized patients, who has been diagnosed Connective Tissue Disease, including systemic lupus erythematosus (SLE), rheumatoid arthtitis (RA), Polymyositis/dermatomyositis (PM/DM), systemic sclerosis(SSc) and Sjogren's syndrome (SS) in the first Affiliated Hospital of Dalian Medical University from January 2006 to December 2010, incidence and clinical data are collected and analysised.Results: Of the 464 cases, 83 patients has Interstitial Lung Disease (ILD), while 21 male and 62 female average aged 60.01±14.21. The total incidence is 17.9%, as RA26.8%, SLE6.5%, DM/PM 23.5%, SSc38.5%, and SS18.5% separately, which has significant differences. All of the cases, 75 patients present primary connective tissue disease symptoms with the incidence was 90.7%, and 8 patients present respiratory symptoms with the incidence rate was 9.3%. Respiratory symptoms mainly present shortness of breath (59%) and cough (53%). Systemic symptoms mainly present joint pain (56.6%) and fever (40.9%). Chest CT mainly shows grid shadow ( 46 cases,57.5%),honeycomb shadow(25 cases, 31.2%), interlobular thickening (34 cases, 42.5%)and pleural thickening(22 cases, 27.5%). 47 cases of arterial blood gas analysis show hypoxemia (19 cases, 40.4%) and type 1 respiratory failure (15 Cases, 31.9%). 16 patients have taken routine pulmonary function tests, while 6 cases are restrictive ventilatory dysfunction, 9 cases of decreased diffusion capacity and 1 case of mixed ventilation dysfunction. Only 2 cases have taken bronchoscope tests, while the pathology both suggest interstitial fibrosis and chronic inflammatory cell infiltration.Conclusion: Interstitial Lung Disease complicated by Connective Tissue Disease can be primary symptoms or respiratory symptoms, such as cough and shortness of breath after activation. Chest CT mainly shows grid shadow, honeycomb shadow, interlobular thickening and pleural thickening.The high-resolution CT (HRCT) is currently the main basis for diagnosis.Arterial blood gas analysis shows hypoxemia. Pulmonary function test mainly shows restrictive ventilatory dysfunction and decreased diffusion capacity . A patient who has connective tissue disease should take chest CT on purpose of early detection of lung involvement, then start therapy as early as possible.