Clinical Characteristics Of Interstitial Pneumonitis With Autoimmune Features (IPAF) And Risk Factors Affecting Their Death

Objectives This study collected the clinical data of interstitial lung disease(IPAF)and interstitial lung disease(CTD-ILD)caused by connective tissue disease with autoimmune characteristics,analyzed the similarities and differences between the two diseases in basic information,clinical characteristics,summarized the characteristic manifestations of IPAF,and analyzed the risk factors affecting IPAF death.To improve physicians understanding of this type of disease,clear IPAF diagnosis,treatment and prognosis.Methods Selected 56 patients who were hospitalized in our hospital from 2013 to 2020 and met the latest IPAF diagnostic criteria,72 patients who met the CTD-ILD were selected as the subjects.The similarities and differences between the two diseases in general data,clinical characteristics and treatment methods were analyzed.According to the survival of IPAF patients,case-control studies were conducted.Single-factor and multi-factor logistic regression models were used to analyze the risk factors affecting the death of IPAF patients.Results 1 IPAF patients compare with CTD-ILD patients,gender,smoking and age were not statistically significant(P>0.05).Cough and expectoration were the most common lung manifestations in the IPAF group,The most common extra-pulmonary manifestations were joint swelling and pain.Cough,velcro rales and extra-pulmonary joint swelling and pain,all the differences were statistically significant(P<0.05).The serum autoimmunity antibody in IPAF group was ANA over 1:320 with high positive rate,The serological manifestations of the two groups were ANA over 1:320,RF,anti SSA antibody and anti CCP antibody were statistically significant(P>0.05).The main manifestations of IPAF group were NSIP,The proportion of the two groups merging OP types in NSIP,difference was statistically significant(P<0.05).The ratio of IPAF group to CTD-ILD group in blood gas analysis and pulmonary function classification,all the differences were not statistically significant(P>0.05).The proportion of patients with glucocorticoid in IPAF group was higher than that in CTD-ILD,group The proportion of patients with immunosuppressants and traditional Chinese medicine preparations was lower than that in CTD-ILD group(P<0.05).2 The IPAF patients were divided into 12 IPAF death group and 36 IPAF nondeath group according to their survival.single and multi-factor logistics regression analysis found that age over 65,anti Jo-1 antibody,UIP and severe CO dispersion dysfunction were the risk factors for the death of the patients.Conclusions 1 There was no difference between IPAF and CTD-ILD in age ratio,sex ratio and smoking ratio.The incidence of cough and expectoration in IPAF lungs was higher than that in CTD-ILD.The incidence of Velcro rales is lower than that of CTDILD.IPAF most common extra-pulmonary manifestations are joint swelling.However,the incidence of joint swelling and pain and skilled hand were lower than that of CTDILD.IPAF serological manifestations were ANA>1:320.The positive rate of ANA>1:320,RF,CCP,SSA antibody was lower than that of CTD-ILD.IPAF was dominated by high positive NSIP,IPAF imaging findings showed a higher incidence of NSIP combined OP than the CTD-ILD.2 Age over 65,Jo-1 antibodies,UIP,severe diffuse dysfunction(DLCO% less than 40%)were risk factors for IPAF death.Figure 1;Table 11;Reference 150...