Interstitial Lung Disease In Patients With Connective Tissue Diseases

Objective : 1.Study the characteristics of clinical symptoms, laboratory examination and imaging examination to guide the clinical diagnosis and treatment of connective tissue diseases with interstitial lung disease(CTD - ILD) 2.Further explore the differences between CTD - ILD individually and CTD - ILD with PAH on clinical symptoms, auxiliary examination. Analyze the role of PH in the development of CTD-ILD and its clinical significance.Method: 1.Use retrospective table to record. 54 cases of hospitalized patients who were clearly diagnosed with CTD- ILD in the dpartment of rheumatism and immunology from January 2016 to January 2017 in the second affiliated hospital of kunming medical university were retrospectively analyzed. The studied patients in this paper are grouped into six groups: RA-ILD?SS-ILD?SSC-ILD?PM/DM-ILD?OLS-ILD?SLE-ILD 2. 54 cases included in the object can be divided into PH group and unincorporated PH group, use the chi-squared test to analysis differences between the two groups of clinical symptoms, laboratory and imaging examination, explore the role of PH in the development of CTD - ILD disease and its clinical significance.Result : 1.Ofpatients eligible for inclusion in 54 cases, by the completely random design analysis of variance: The onset age ofCTD -ILD?the average time of the CTD diagnosis to the CTD-ILD diagnosis in six groups were statistically significant (P<0.05) in six groups were statistically significant (P<0.05) . The result of further analysis of LSD -t: in addition that SLE - ILD had statistically significant difference with the other 5 groups, there were no statistically significant difference between the other 5 groups. SLE-ILD group has a earlier onset age. Besides, The average time of the SLE diagnosis to the SLE-ILD diagnosis in six groups were statistically significant (P<0.001).2. All groups of patients have shortness of breath, cough, oppression in chest and Raynaud's p he no me no n. Differe nt groups of CTD - ILD have different clinical manifestations. Among them respiratory symptom as the initial symptom, Raynaud's phenomenon, dyspnea ,cough was statistically significant different (P<0.05) .The incidence of respiratory symptom as the initial symptom [22.2%, 55.6%, 40%,72.7%, 33,3%, 16.7%,respectively, (P<0.05)] ; Raynaud's phenomenon[33.3%,44.4%, 80.0%, 63.6%, 33.3%, 16.7%,respectively, (P<0.05)];dyspnea[22.2%,33.3%, 60.0%, 72.7%, 44.4%, 33.3%,respectively, (P<0.05) ];cough[88.9%,77.8%, 20%, 90.9%, 66.7%, 66.7%,respectively, (P<0.05)].3. In this study of 54 patients with CTD - ILD, tht main manifestation of Chest computed tomography (CT) include ground-glass opacity (51.9% ) , reticular opacity(40.7% ) and honeycombing opacity (7.4%) . Among them ground-glass opacity and reticular opacity have statistically significant difference (P<0.05). The incidence of ground-glass opacity [33.3 %, 66.7%, 30%, 45.5%, 66.7%, 83.3%,respectively,(P<0.05) ], reticular opacity[55.6 % , 22.2%, 70%, 36.4%, 33.3%,16.7%,respectively, (P<0.05)].4.Among the autoimmune antibodies of CTD,RO-52 antibody?Scl-70 antibody?JO-1 antibody have statistically significant difference (P<0.05) . The incidence of RO-52 antibody [11.1%, 100%, 20%, 90.9%, 77.8%, 0.00 %,respectively, (P<0.05)].The positive rate of Scl - 70 antibody in SSC group was the highest, far higher than other groups. The positive rate ofJO-1 antibody in PM/DM group was the highest, far higher than other groups.5.Among the 54 CTD-ILD, there are 14 with PH and 40 without PH.The group with PH has a higher incidence rate of Raynaud's phenomenon , dyspnea, cough, CT reticular opacity ,CT honeycombing opacity and rheumatoid factor. The group without PH has a higher incidence rate of CT ground-glass opacity. Among patients with CTD-ILD and PH, chest CT performance for ground glass shadow has 1 case(7.1%), honeycomb shadow has 4 cases (28.6%), grid shadow has 9 cases (64.3%).Conclusion : 1. In this study, PM/DM-ILD patients are prone to respiratory symptoms and often with respiratory symptoms as first symptoms. Raynaud's phenomenon can occur in all the CTD - ILDs, of which SSC - ILD has the highest incidence of Raynaud's phenomenon.2. Chest CT performance of CTD-ILD :.RA and SSC are mainly of reticular opacity performance,RA?SSC and OLS are mainly of ground-glass performance.3. PM/DM - ILD has a high rate of positive antibody of JO -1 and RO - 52. SSC -ILD has s a high rate of positive antibody of Scl-70.4. Raynaud's phenomenon and the rise of RF can be used as predictors of PH. PH combined with CTD - ILD show more grid shadow and honeycomb shade,The emergence of the PH often prompts that CTD - ILD is in the late course of pulmonary fibrosis stage. PH can be used as a sign to evaluate the condition of CTD - ILD, and prompts poor outcome.