摘要
目的探讨自身免疫特征的间质性肺炎(interstitial pneumonia with autoimmune features,IPAF)与结缔组织病相关间质性肺疾病(connective tissue disease-interstitial lung disease,CTD-ILD)中支气管肺泡灌洗液(bronchoalverolar lavage fluid,BALF)细胞分类计数及其他临床特征的异同。方法回顾性分析2014年1月~2017年12月我科行支气管肺泡灌洗检查的间质性肺疾病47例的临床资料,其中CTD-ILD组28例(干燥综合征12例,类风湿关节炎4例,肌炎/皮肌炎11例,系统性硬化1例),IPAF组19例。比较2组临床表现、BALF特征、肺功能及影像学表观等的差异。结果 CTD-ILD组BALF中性粒细胞计数较IPAF组显著增高[中位数2.27(0.03~18.90)×10~4/ml vs.0.60(0.09~5.19)×10~4/ml,Z=-2.613,P=0.009]。CTD-ILD组比IPAF组更年轻[(56±13)岁vs.(65±10)岁,t=-2.546,P=0.014],皮肤表现多[46%(13/28)vs.11%(2/19),χ2=6.714,P=0.010],干燥症状少[18%(5/28)vs.53%(10/19),χ2=6.299,P=0.012]。2组性别构成、其他症状、肺功能无显著性差异(P>0.05)。2组血清学自身抗体及影像学表现均无显著性差异(P>0.05)。结论 BALF中性粒细胞升高可能是CTD-ILD区别于IPAF的特异性表现。
Objective To explore the characteristics of bronchoalverolar lavage fluid(BALF)cytology and clinical features of patients in interstitial pneumonia with autoimmune features(IPAF)and connective tissue disease-associated interstitial lung disease(CTD-ILD).Methods A retrospective analysis was performed in47cases of interstitial lung disease admitted to our hospital and received bronchoalverolar lavage from January2014to December2017,including28patients with CTD-ILD[12cases of Sjogren,s syndrome(SS),4cases of rheumatoid arthritis(RA),11cases of polymyositis/dermatomyositis(PM/DM)and1case of systemic sclerosis(SSc)]and19patients with IPAF.Clinical manifestations,BALF cytology,pulmonary function and radiological features were compared between CTD-ILD and IPAF.Results Patients with CTD-ILD had a significant higher neutrophil counts as compared with patients with IPAF[median,2.27(0.03-18.90)x l〇4/ml vs.0.60(0.09-5.19)x l〇4/ml,Z=-2.613,P=0.009].As compared with patients with IPAF,patients with CTD-ILD were younger[(56±13)years old vs.(65±10)years old,J=-2.546,P=0.014],had more skin lesions[46%(13/28)vs.11%(2/19),=6.714,P=0.010]and fewer dry symptoms[18%(5/28)vs.53%(10/19)^x=6.299,P=0.012].The difference of gender composition,other symptoms,lung function,serum autoantibodies and radiological features between the two groups did not show statistical significance(P>0.05).Conclusion An increase of neutrophilia counts in BALF may contribute to the early identification of CTD-ILD as compared to IPAF.
作者
杜毅鹏
葛欣宜
周晨
张雪阳
沈宁
贺蓓
Du Yipeng;Ge Xinyi;Zhou Chen(Department of Respiratory Medicine, Peking University Third Hospital y Beijing 100191, China)
出处
《中国微创外科杂志》
CSCD
北大核心
2018年第3期220-224,共5页
Chinese Journal of Minimally Invasive Surgery
基金
北京大学第三医院种子基金
关键词
支气管肺泡灌洗液
自身免疫特征的间质性肺炎
结缔组织病相关间质性肺疾病
临床特征
Bronchoalveolar lavage fluid
Interstitial pneumonia with autoimmune features
Connective tissue disease-associated interstitial lung disease
Clinical characteristics
