Clinical Retrospective Analysis Of Interstitial Lung Disease Associated With Pulmonary Hypertension

Research background:Interstitial Lung Disease(ILD) is a group of diseases due to Interstitial Lung injury caused by different sources, imaging features shows diffusivity pulmonary interstitial change. With increasing and progressing of the interstitial lung disease illness,Inflammation spread to neighboring interstitial and blood vessels, These reasons lead to pulmonary fibrosis, Function of gas exchange barrier and ventilation is reduced, pulmonary function shows dysfunction of restrictive ventilatory and reducing of diffusion function. Hypoxemia and pulmonary interstitial fibrosis often leads to pulmonary hypertension. Pulmonary hypertension is a common complication of interstitial lung disease and is the leading cause of death and disability in these patients.the progress of the basic and clinical research about Interstitial lung disease related to pulmonary hypertension has been slow, The quality of life and prognosis of these patients have no obvious improvement, most of the data at abroad has been obtained from studies conducted on patients referred as candidates for lung transplant. The domestic studies of interstitial lung disease related to pulmonary hypertension is poor. A few of research about pulmonary hypertension focused on connective tissue diseases. Study about the morbidity of pulmonary hypertension in Interstitial Lung Disease and the correlation of pulmonary hypertension and pulmonary function was poor.Objective:Take the imaging features of HRCT shows diffusivity pulmonary interstitial change as the diagnostic criteria of interstitial lung disease and take ’PASP(pulmonary artery systolic pressure levels)≥40mmhg’ by ultrasonic cardiogram as the diagnostic criteria of Pulmonary hypertension, we made an retrospective analysis about the morbidity of pulmonary hypertension in Interstitial Lung Disease and the correlation of pulmonary hypertension and pulmonary function.Methods:An retrospective analysis was performed in 514 patients with Interstitial Lung Disease in Shandong provincial hospital between october 2012 and November 2014.there were 216 patients Conform to the standard and their pulmonary artery systolic pressure levels were estimated by ultrasonic cardiogram.An contrastive analysis was performed about the morbidity of pulmonary hypertension in these patients (antinuclear antibody -positive)of the 216 cases, these patients (antinuclear antibody-negative) of the 216 cases and all of the patients.116 patients to the 216 cases had complete pulmonary function records, linear correlation analyses were performed between PASP and pulmonary function in these patients (antinuclear antibody-positive) of the 116 cases, these patients (antinuclear antibody-negative) of the 116 cases and all of the 116 patients.Results:There were 54 cases patients with PASP ≥40mmhg in the above 216 cases, Take PASP ≥40mmhg by ultrasonic cardiogram as the diagnostic criteria of Pulmonary hypertension, The morbidity of pulmonary hypertension was 25%; There were 14 cases with PASP ≥60mmhg in the above216 cases, Take PASP ≥60mmhg by ultrasonic cardiogram as the diagnostic criteria of Severe Pulmonary hypertension,The morbidity of Severe pulmonary hypertension was 6.48%. there were 126 cases with test result of antinuclear antibody-positive,28 cases with PASP ≥40mmhg, The morbidity of pulmonary hypertension in this cases was 22.22%. there were 56 cases with test result of antinuclear antibody-negative,18 cases with PASP ≥40mmhg, The morbidity of pulmonary hypertension in this cases was 32.14%.116 cases had pulmonary function test during in the hospital of the above 216 cases,PASP and pulmonary function were analyzed with Spearman’s linear correlation analysis, the results showed that moderate relationships existed between DLCO、FVC%、VC% and PASP,how ever, MVV、 FEV1/FVC%、RV/TLC was not correlated with PASP.the 116 cases were grouped into antinuclear antibody-positive and antinuclear antibody-negative,Linear correlation analysis showed that moderate relationships existed between DLCO and PASP in both the two groups,minuent relationships existed between FVC%、VC% and PASP in the group of-antinuclear antibody positive and moderate relationships existed between FVC%、VC% and in the group of antinuclear antibody-negative.Conclusion:The morbidity of pulmonary hypertension in Interstitial Lung Disease are relatively high, The morbidity of pulmonary hypertension in different types of interstitial lung disease is not the same. Take PASP ≥40mmhg by ultrasonic cardiogram as the diagnostic criteria of Pulmonary hypertension, The morbidity of pulmonary hypertension in Interstitial Lung Disease was 25% in the study above,the morbidity was 32.14% in the group of antinuclear antibody-negative and 22.22% in the group of ANA-positive, The results suggest that The morbidity of pulmonary hypertension in the group of antinuclear antibody-negative were higher than the group of antinuclear antibody-positive.Moderate relationships existed between PASP and DLCO、VC%、FVC% in the patients with Interstitial Lung Disease, the group of ANA-negative had higher relationship than the group of antinuclear antibody-positive.