Analysis Of Clinical Characteristics Of Connective Tissue Disease-associated Interstitial Lung Disease

Objective: To understand the prevalence of various connective tissueassociated interstitial lung disease.Compare the clinical characteristics of patients with single connective tissue-related interstitial lung disease and patients with overlap connective tissue-associated interstitial lung disease,so as to better understand connective tissue-associated interstitial lung disease,to supply information for clinical application.Methods: Through the medical record system,the medical records of patients with definited connective tissue disease who visited the second affiliated hospital of chongqing medical university from January 2016 to January 2018 were collected for retrospective analysis.Detailed data of patients with interstitial lung disease-associated connective tissue disease were collected,and the differences in general data,clinical characteristics,serological manifestations and chest imaging data between patients with interstitial lung disease-associated single connective tissue disease and patients with interstitial lung disease-associated overlap connective tissue disease were analyzed.The diagnosis of CTD and ILD are in accordancewith internationally recognized diagnostic criteria,the patients with other known causes of ILD and other pulmonary diseases were excluded.Results: 1.There was a significant difference in the prevalence of all kinds of CTD-ILD(P < 0.001).The highest prevalence was 66.67% for PM/ DM-ILD,the lowest was 6.40% for SLE-ILD,and the prevalence of OCTD-ILD was 40.5%.2.In CTD-ILD patients,the incidence of symptoms related to connective tissue disease such as joint swelling or pain,morning stiffness,dry eye or mouth,was higher than lung related manifestations of cough,sputum,dyspnea,Vecrol rale.Compared with SCTD-ILD group,the symptoms of dyspnea(41.3% vs20.0%,p=0.006),sensitive to light(13.0%VS1.9%,p=0.01),hair loss(26.1%VS7.6%,p=0.002),Raynaud's phenomenon(37.0% vs15.2%,p=0.003),Vecrol rale(39.1%VS21.0%,p=0.02)were more common in OCTD-ILD group.3.In terms of laboratory examination results,compared with the SCTD-ILD group,patients in the OCTD-ILD group had higher immune globulin G,higher AST,higher creatine kinase,and lower fibrinogen,leukocyte count,and hemoglobin,but the median of leukocyte count,AST,creatine kinase was within the normal range of laboratory reference values.4.In terms of immunological examination,the positive rates of anti-nuclear antibody,anti-SSA antibody,anti-Ro-52 antibody,anti-SSB antibody,and anti-Jo-1 antibody in the OCTD-ILD group were significantly higher than those in the SCTD-ILD group(p=0.005,p < 0.001,p=0.005,p=0.033,p=0.024).5.In terms of HRCT images of the chest,the most common image manifestation of CTD-ILD was patchy shadow,followed by ground glass shadow,pleural thickening,and low incidence of honeycomb shadow.In the OCTD-ILD group,pleural effusion was more likely to occur(p=0.024).Conclusion: There is a high prevalence of CTD complicated ILD,the clinical manifestations are complex and varied.There are differences in clinical characteristics and laboratory examinations between patients with OCTD-ILD and those with SCTD-ILD,during the follow-up of CTD-ILD patients,it was still necessary to pay attention to its CTD,and in the case of certain characteristics,it was necessary to screen for multiple CTD overlaps in order to develop a better therapeutic regimen.