Clinical Analysis Of Connective Tissue Disease Starting With Interstitial Lung Disease

ObjectiveTo analyze the general situation,clinical manifestations,laboratory examination and imaging characteristics of patients with interstitial lung disease(ILD)and connective tissue disease-associated interstitial lung disease(CTD-ILD),in order to explore the differences in clinical data between patients with ILD and those with ILD.MethodA retrospective analysis was performed on 161 cases diagnosed with ILD in the respiratory department of China-Japan Friendship Hospital of Jilin University from September 2020 to January 2023.The general conditions were as follows: course of disease,gender,age,clinical manifestations: Cough and phlegm,chest tightness,fever,fatigue,joint pain,dry mouth and eyes,lung wet rales,lung velcro rales,Raynor’s phenomenon,rash,oral ulcers.Laboratory tests include: Total red blood cell count(RBC),whole blood white blood cell count(WBC),hemoglobin(HGB),serum total protein(TP),serum albumin(ALB),serum globulin(GLB),serum total cholesterol(CHOL),triglyceride(TC),tumor markers(CA19-9,CA125,CA153),carcinoembryonic antibody(CEA),neuron-specific enolase(NSE),C-reactive protein(CRP),erythrocyte deposition rate(ESR),immunoglobulin(Ig G,Ig M,Ig A),complement(C3,C4),anti-cyclic citrullinated peptide antibody(anti-CCP antibody),anti-neutroplasmic antibody(ANCA),anti-cardiolipin antibody(ACA),anti-nuclear Antibody screening(ANA),imaging findings: lesion location,ground glass shadow,patch shadow,fiber cable shadow,mesh shadow.According to the clinical diagnosis after admission,patients with connective tissue disease(CTD-ILD group with connective tissue disease;The ILD group without connective tissue disease was divided into two groups for comparative analysis.Statistical methods: SPSS 27.0 statistical software was used for statistical analysis.Data conforming to normal distribution was expressed as mean ±standard deviation(x ± s),while data conforming to non-normal distribution was expressed as median(upper quartile,lower quartile).t test was used to compare measurement data of two groups conforming to normal distribution,and Man-Whitney U test was used to compare measurement data of two groups conforming to normal distribution.One-way analysis of variance was used to compare the three groups of data,and chi-square test was used to compare the count data.P<0.05 meant the difference was statistically significant.Result1.Among 161 ILD patients,31 patients had CTDS(19%),including 9 patients had rheumatoid arthritis(RA)complicated with interstitial lung disease(29%),6patients had Sjogren’s syndrome(SS)complicated with interstitial lung disease(19%),and 4 patients had ANCA-associated vasculitis complicated with interstitial lung disease(AASV-ILD)(13%).Polymyositis(PM)/dermatomyositis(DM)complicated with interstitial lung disease in 3 cases(10%),systemic lupus erythematosus(SLE)complicated with interstitial lung disease in 3 cases(10%),systemic sclerosis(SSc)complicated with interstitial lung disease in 1 case(3%),undifferentiated connective tissue disease(UCTD)complicated with interstitial lung disease in 5 cases(16%).2.In this study,the incidence of CTD-ILD was 11.1% in males and 25.3% in females,and the difference between the two groups was statistically significant(P<0.05).The age of patients in CD-ILD group was significantly younger than that in ILD group,and the difference between the two groups was statistically significant(P<0.05).3.The proportion of patients with arthralgia,dry mouth and dry eyes,Raynaud’s phenomenon,rash and oral ulcer in CTD-ILD group was significantly higher than that in ILD group,and the difference was statistically significant(P<0.05).4.Serum total protein and serum albumin in CTD-ILD group were significantly lower than those in ILD group.CA153 was significantly higher in CTD-ILD group than in ILD group.The differences among the above laboratory test groups were statistically significant(p<0.05).There was no statistical significance in CA19-9,CA125,CEA and NSE groups(P > 0.05).5.There were significant differences in the positive rate of anti-CCP antibody between RA-ILD group and all subgroups in CTD-ILD group(P < 0.05),but there were no significant differences in the positive rate of other autoantibodies among all subgroups(P > 0.05).Conclusion1.The majority of CTD-ILD patients who were first ILD were relatively young women.2.Arthralgia,dry mouth and dry eyes,Raynaud’s phenomenon,rashes and oral ulcers are important clinical manifestations in patients with ILD.3.The serum total protein and serum albumin levels were lower in patients with CTD,and the CA153 levels were higher in patients with CTD.4.There was no significant difference in the positive rates of ANA and ANCA among the subgroups of CD-ILD.