摘要
目的 探讨职业性尘肺病(以下简称"尘肺病")合并间质性肺炎(ILD)的临床特点.方法 采用回顾性研究方法,选择56例尘肺病合并ILD患者为研究对象,分析其临床特征.结果 56例患者的临床症状主要为进行性呼吸困难、咳嗽和咳痰,检出率分别为76.8%、75.0%和55.4%;低氧血症、呼吸衰竭检出率分别为67.9%和32.1%.35例完成肺功能检查的患者中,限制性、混合性、阻塞性通气功能障碍检出率分别为37.1%、22.9%和17.1%,弥散功能降低检出率为74.3%.胸部高分辨电子计算机断层扫描可见磨玻璃状阴影、网格状阴影、小叶间隔增厚、蜂窝状阴影和牵拉性支气管扩张,检出率分别为57.1%、35.7%、35.7%、23.2%和17.9%;病变多为两肺弥漫性分布,下肺分布多于中上肺.有19例(占33.9%)患者合并结缔组织疾病,包括合并系统性硬化症、类风湿性关节炎、系统性红斑狼疮、多发性肌炎与皮肌炎.结论 尘肺病合并ILD患者的临床症状、肺功能与血气分析结果均无特异性,但部分尘肺病患者合并ILD的同时可合并有结缔组织疾病.
Abstract
Objective To explore the clinical features of occupational pneumoconiosis(hereinafter referred to as"pneumoconiosis")complicated with interstitial lung disease(ILD).Methods A total of 56 patients with pneumoconiosis complicated with ILD were selected as the research subjects using a retrospective study method,and their clinical features were analyzed.Results The main clinical symptoms of the 56 patients were progressive dyspnea,cough,and expectoration,with detection rates of 76.8%,75.0%,and 55.4%,respectively.The detection rates of hypoxemia and respiratory failure were 67.9%and 32.1%respectively.Among the 35 patients who underwent pulmonary function test,restrictive,mixed,and obstructive ventilatory disorders were detected in 37.1%,22.9%,and 17.1%of cases,respectively,with a 74.3%detection rate for reduced diffusion capacity.High resolution computed tomography of the chest revealed ground-glass shadows,grid shadow,interlobular thickening,honeycomb shadows and tractive bronchiectasis,with detection rates of 57.1%,35.7%,35.7%,23.2%,and 17.9%,respectively.Lesions were mostly diffusely distributed in both lungs,with a predominance in the lower lungs compared to the mid-upper lungs.Patients complicated with connective tissue disease,including systemic sclerosis,rheumatoid arthritis,systemic lupus erythematosus,polymyositis,and dermatomyositis,accounted for 33.9%(19 cases).Conclusion The clinical symptoms,pulmonary function,and arterial blood gas analysis results of patients with pneumoconiosis complicated with ILD show no specific features.However,a subset of pneumoconiosis patients with ILD also have coexisting connective tissue diseases.
基金项目
广西壮族自治区健康委员会科技研究计划课题(Z20200940)
NETL
NSTL
万方数据