Correlative Analysis Of Interstitial Pneumonia With Autoimmune Features And Connective Tissue Disease-associated Interstitial Lung Disease

Objective: In this paper,we analyzed the clinical data of Interstitial pneumonia with autoimmune features(IPAF)and Connective tissue disease-associated interstitial lung disease(CTD-ILD).summarizes the similarities and differences between IPAFand CTD-ILD,So that clinicians have increased awareness of IPAF,IPAF patients get early diagnosis and treatment,thereby improving the prognosis,slow disease progression.Methods: A total of 79 patients with ILD were enrolled in the Department of Respiratory Medicine,the First Affiliated Hospital of Dalian Medical University from January 1,2013 to December 31,2016.Among them,Among them,48 patients with IPAF.31 patients with CTD-ILD,Through retrospective analysis of the two in the basic data,clinical features,blood gas analysis,lung function,imaging differences.Results: Of the 79 patients,48 were IPAF,including 18 males and 30 females with age distribution between 45 and 85 years old.IPAF patients with respiratory system mainly cough,sputum in 35 cases(72.92%),dyspnea in 33 cases(68.75%).The performance of extra-pulmonary system was mainly 16 cases(33.33%)of dry symptoms,11 cases(22.92%)of joint swelling and pain.CTD-ILD patients in 31 cases,12 males and 19 females,aged between 47 to 87 years old,including rheumatoid arthritis(RA)in 9 cases,Sjogren's syndrome(p SS)in 15 cases,myositis / skin Myocarditis(PM / DM)4 cases,systemic lupus erythematosus(SLE)2 cases,systemic sclerosis(SSc)1 case.Five patients were diagnosed with CTD and then diagnosed with ILD,including 4 patients with rheumatoid arthritis(RA)and 1 patient with systemic lupus erythematosus(SLE).Twenty-three patients were diagnosed with CTD and ILD during hospitalization.Four patients were diagnosed with ILD and CTD,including 2 cases of myositis(PM),1 case of dermatomyositis(DM)and 1 case of Sjogren's syndrome(p SS).CTD-ILD patients with respiratory system mainly cough,sputum in 25 cases(80.64%),dyspnea in 24 cases(77.42%).The performance of extra-pulmonary system was 21 cases(67.74%)of joint pain and 10 cases(32.26%)of dry symptoms.Forty-six patients with IPAF serological antibody were mainly concentrated in anti-nuclear antibody ?1: 320 25 cases,anti-SS-A antibody(+)12 cases,anti-Ro-52 antibody(+)24 cases.31 patients with CTD-ILD were serially positive in anti-nuclear antibody ?1: 320 21 cases,anti-SS-A antibody(+)16 cases,anti-Ro-52 antibody(+)15 cases,anti-SS-B Antibody(+)in 8 cases,anti-CCP antibody(+)in 6 cases.Of the 48 patients with IPAF,20(41.67%)had normal blood gas analysis,28(58.33%)had abnormal blood gas analysis,21(43.75%)were hypoxemia,7(14.58)%),No type ? respiratory failure.There were 9 cases(29.03%)of CTD-ILD patients with normal blood gas analysis,22 cases(70.97%)had abnormal blood gas analysis results,including 18 cases(58.06%)of hypoxemia,2 cases of type ? respiratory failure(6.45%),Type ?respiratory failure in 2 cases(6.45%).IPAF patients with normal pulmonary function in 3 cases,restrictive ventilatory dysfunction in 7 cases,including mild restrictions in 3 cases,moderate limit in 4 cases,severe restrictions in 0 cases.18 cases of diffuse dysfunction,including mild diffuse disorder in 10 cases,moderate diffusion disorder in 3 cases,severe diffusion disorder in 5 cases.Obstructive ventilatory dysfunction in 4 cases,mixed ventilatory dysfunction in 3 cases,VCpred(%)was 75.13 ± 3.23,TLCOpred(%)was 63.64 ± 23.08.CTD-ILD patients with normal pulmonary function in 2 cases,restrictive ventilation dysfunction in 3 cases,including mild limited 0 cases,moderate limit in 3 cases,severe restrictions in 0 cases.Diffuse dysfunction in 13 cases,including mild diffuse disorder in 7 cases,moderate diffusion disorder in 2 cases,severe diffusion disorder in 3 cases.Obstructive ventilatory dysfunction in 9 cases,mixed ventilatory dysfunction in 5 cases,VCpred(%)was 65.78 ± 16.78,TLCOpred(%)was 53.00 ± 21.76.Conclusions: There is no significant difference in age and sex between sexually transmitted pneumonia(IPAF)and connective tissue disease-related interstitial lung disease(CTD-ILD),both of which are common in female patients.IPAF patients with respiratory symptoms mostly cough,sputum and difficulty breathing,a small number of fever,multi-system manifestations of dry lungs mainly dry symptoms,joint swelling and pain,which suffering from joint swelling and pain(22.92%)patients with CTD-ILD(67.74 %),The reasons may be related to the gradual progress of the disease,the symptoms were significantly increased.CTD-ILD(19.35%)patients were more likely to be associated with some patients with CTD-ILD in patients with connective tissue disease.Serum autoantibody positive in patients with IPAF was mainly concentrated in anti-nuclear antibody ?1: 320,anti-SS-A antibody,anti-Ro-52 antibody.Compared with CTD-ILD patients,anti-SS-A antibody(+),anti-CCP(+)patients less.Therefore,if the serological anti-SSA antibody(+),but also need to lacrimal gland secretion test or lip line biopsy to be a clear diagnosis.IPAF patients with HRCT NSCT more common,CTD patients with more common HRCT NSIP and UIP.Both IPAF and CTD-ILD had varying degrees of restrictive ventilatory dysfunction and diffuse function,and some had even obstructive ventilatory dysfunction,but were mainly diffuse dysfunction(69.23% vs 70.58%)?...