| BackgroundDiffuse connective tissue disease(connective tissue disorrders,ctds)is caused by the abnormality of autoimmune system,and it is generally believed that diffuse connective tissue disease is related with heredity,environment and dysfunction of autoimmune system,pathogenesis is unknown,However,diffuse connective tissue disease can almost affect every organ of the organism,which has a serious effect.Interstitial lung disease(interstitial lung disease,ild)is the most common involved organ,and the prognosis is poor,the mortality is high,there is no effective drugs can be thoroughly treated.The main pathological changes of pulmonary interstitial lesions in diffuse connective tissue disease mainly include alveolar,pulmonary interstitial and bronchial tissue inflammation of different degrees of inflammatory cell infiltration and fibrosis characteristics,resulting in the reduction of lung ventilation units,the formation of respiratory failure,resulting in death.At present,the treatment of interstitial lung disease in diffuse connective tissue disease can only prevent and postpone the progression of the disease only by early initiation of immunosuppression.To enable rapid diagnosis of diffuse connective tissue disease interstitial lung disease,the American Thoracic Society and the European Respiratory Association in 2013 divided interstitial lung disease into 3 major and 8 subtypes,although the diagnostic criteria for interstitial lung disease are defined to a certain extent,there is a lack of typical clinical manifestations of interstitial lung disease in diffuse connective tissue disease,It is still very difficult to make a definite diagnosis for the complex and changeable image classification and pathological type.Therefore,it is of great significance to find the method of detecting interstitial lung disease in diffuse connective tissue disease which can be easily and easily accepted by patients.ObjectiveInterstitial lung disease of connective tissue disease clinical and imaging data and laboratory results of analysis,aims to find out the connective tissue disease sex and clinical features of interstitial lung disease and serological related characteristics,in order to provide evidences for early diagnosis of the disease.MethodsChoose between December 2015 and December 2017 in(the)hospital inpatient li rheumatism lead of connective tissue disease,100 patients with interstitial lung disease diagnosis for the team,at the same time choose unincorporated interstitial connective tissue disease treated at our hospital in 100 patients with interstitial lung disease diagnosis as the control group 1,line selection in our hospital health check volunteer 2 100 cases as control group,the clinical data of 3 groups,laboratory indexes,image data and serum markers related to apply social science statistical package(stastical package for social science,SPSS)14.0 system line between groups difference analysis.Results1.There was no statistically significant difference between the three groups in the general data of age and sex(P BBB 0.05);Group,100 cases of patients,rheumatoid arthritis with interstitial lung diseases(RA-LID)14 cases(14.00%),systemic lupus erythematosus(SLE)with interstitial lung disease(SLE-ILD)13 cases(13.00%),systemic sclerosis with interstitial lung disease(SSc-ILD)in 16 cases(16.00%),dermatomyositis with interstitial lung diseases(DM-ILD)in 16 cases(16.00%),multiple myositis with interstitial lung diseases(PM-ILD)19 cases(19.00%),mixed sex connective tissue disease merger interstitial lung disease in 16 cases(16.00%),sjogren's syndrome with interstitial lung disease,6 cases(6.00%).2.Comparison of clinical manifestations between the research group and the control group: the number of patients with cough,expectoration,chest tightness and joint pain was significantly higher than that in the control group,with statistically significant differences(P<0.05).Compared with other clinical manifestations,the difference was not statistically significant(P BBB 0 0.05).3.group: compared with control group 1 autoantibody team antinuclear antibodies,SSB antibody resistance,resistance to Jo-1 antibodies were significantly control group 1 group,anti CCP antibody significantly lower than the control group 1,compare the difference was statistically significant(P < 0.05),while other antibodies,there was no statistically significant difference(P > 0.05).3 The study group was compared with the control group: Team antinuclear antibodies,SSB resistance,resistance to Jo-1 antibodies were significantly control group 1 group,anti CCP antibody significantly lower than the control group 1,compare the difference was statistically significant(P < 0.05),while other antibodies,there was no statistically significant difference(P > 0.05).4.Comparison of other laboratory indicators in the study group and control group: Team hemoglobin,c-reactive protein level obviously higher than that of control group 1,compare the difference was statistically significant(P < 0.05),while other lab index comparison,the two groups were no statistically significant difference(P > 0.05).5.Three groups of serum surface active protein D(sp-d),anti-melanoma differentiation related gene 5(MDA5)antibody,interleukin-6(il-6)and tumor necrosis factor-a(TNF-a)were compared: The levels of sp-d,MDA5,il-6 and TNF-a in the study group were significantly higher than that in the control group,and the differences were statistically significant(P<0.05).Compared with the control group,the above index level was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).6.The relationship between the study group sp-d,anti-mda5 antibody,il-6 and TNF-a in clinical manifestations and laboratory indicators: The level of sp-d in patients with chest tightness was significantly higher than that of patients without chest tightness,and the difference was statistically significant(P<0.05).The level of MDA5 was significantly higher than that of the patients without rashes,and the difference was statistically significant(P<0.05).The level of TNF-a in patients with anemic patients was significantly higher than that of the patients who did not appear anemic,and the difference was statistically significant(P<0.05).7.The relationship between lung function of the study group and sp-d,anti-mda5 antibody,il-6,TNF-a level: The level of sp-d in patients with normal/mild ventilation dysfunction was significantly higher than that in patients with moderate/severe ventilation dysfunction,and the difference was statistically significant(P<0.05).The level of sp-d in patients with normal/mild diffusive dysfunction was significantly lower than that of patients with moderate/severe disseminated dysfunction,and the difference was statistically significant(P<0.05).However,there was no statistical significance in anti-mda5 antibody,il-6,TNF-a and other indicators(P BBB 0 0.05).8.Imaging findings of the study group: Imaging findings in patients with multiple,a patient can appear two or more features of pulmonary interstitial lesions,different combination of symptoms in patients with significant differences on the imaging characteristics of patients with scleroderma and rheumatoid arthritis,dermatomyositis,appear more grid shadow;Systematized scleroderma and rheumatoid arthritis appear in multiple cells;Multiple myositis and systemic lupus erythematosus(sle)are more realistic.Image classification,non-specific interstitial pneumonia(pneumoconiosis)is more common,and there is a statistical significance(P<0.05).9.The relationship between image credit and pathological classification of the research group: There was no significant difference between imaging grade and pathological typing(P>0.05).Conclusion1.different pulmonary interstitial connective tissue disease pathological changes of different clinical manifestations and imaging features,high resolution CT of the disease is of high sensitivity,and anastomosed with the pathological classification has better predict pathological classification by imaging features,prognosis.2.The correlation index of serum markers was highly correlated with the pulmonary interstitial lesions of connective tissue disease,which could help to assess the early diagnosis and prognosis of the disease. |
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