Analysis Of Chest HRCT And Pulmonary Functional Test Of Connective Tissue Disease Associated Interstitial Lung Disease

Objective To investigate the features of chest HRCT and lung function test of connective tissue disease associated interstitial lung disease and the correlation between HRCT score and degree of lung function impairment.Methods We retrospectively reviewed the medical date of 273 patients who were diagnosed of Rheumatoid Arthritis?RA?,primary Sjogren's syndrome?pSS?,Systemic Sclerosis?SSc?,and polymyositis/dermatomyositis?PM/DM?complicated with interstitial lung disease at Ningxia Hui Autonomous Region People's Hospital?including the General Hospital,Xixia Hospital,Ningnan Hospital and Emergency Center?from February 2013 to September 2018,all CTD-ILD patients were selected to complete HRCT and pulmonary function test,and we analyze the features of HRCT and the results of lung function test.The results of lung function test including total lung capacity,forced vital capacity?FVC?,forced expiratory volume in the first second?FEV₁?,FEV₁/FVC,diffusion capacity of the lung for carbon monoxide?DLCO?and DLCO/VA.And we analyze the correlation between the chest HRCT score and the degree of pulmonary function test.Results1.CTD-ILD patients are more common among middle-aged and older women,with 59.3%of CTD-ILD patients with obvious respiratory symptoms,and 40.7%of patients with no obvious respiratory symptoms.2.The basic signs of HRCT in patients with CTD-ILD are as follows:ground glass opacity?55.7%??reticular opacity?45.4%??honeycomb shadow?37.7%??interlobular septal thickening?33.0%??consolidation shadow?32.6%??nodules shadow?19.8%??subpleural line?15.4%??The basic signs of HRCT in RA-ILD patients were mostly ground glass opacity?63.6%?,followed by reticular opacity?51.9%?,honeycomb shadow?49.7%?; pSS-ILD patients with consolidation shadow?39.6%?and ground glass opacity?33.3%?as the main performance;SSc-ILD patients with ground glass opacity?50.0%?and reticular opacity?45.0%?as the main performance;PM/DM-ILD patients with imaging findings were more common in ground glass opacity?38.9%?,followed by interlobular septal thickening?27.8%?and reticular opacity?27.8%?.3.The imaging classification of CTD-ILD patients was mainly UIP?41%?and NSIP?45.4%?.Of the 273 patients,6 were considered to be LIP types based on imaging findings,accounting for 2.2%.2 patients were considered to be OP type,accounting for 0.7%,could not be classified according to the patient's HRCT performance or there were two or more types classified as others?10.6%?.4.The HRCT score of 273 patients was 14.37±8.41.The average HRCT score of RA-ILD patients was 15.74±7.64;pSS-ILD was 11.27±8.84;SSc-ILD was 12.35±10.21;PM/DM-ILD was 10.67±9.74.The average of six lung function indexes were follow TLC was 98.70±9.25,FVC was 85.20±7.99,FEV₁ was of 82.82±10.60,and FEV₁/FVC was83.47±9.00,DLCO was 53.73±6.66,and DLCO/VA was 62.76±9.14.About 261?95.6%?patients had a decrease in carbon monoxide diffusion.5.Through Pearson correlation analysis,there was a significant correlation between FEV₁,FEV₁/FVC,DLCO,DLCO/VA and HRCT score,there was a strong negative correlation r=-0.743,?P<0.01?between HRCT score and DLCO;there was a moderate negative correlation with FEV₁,FEV₁/FVC,r=-0.418,r=-0.425?P<0.01?;DLCO/VA had a weak negative correlation r=-0.327,?p<0.01?;TLC,FVC had a very weak negative correlation with HRCT score or no correlation r=-0.179,r=-0.195,?P<0.01?.Conclusion1.CTD-ILD patients are common in middle-aged and older women.The HRCT imaging classification of RA-ILD patients was mainly UIP type,and the pSS-ILD,SSc-ILD and PM/DM-ILD types were mainly NSIP.The type of lung function impairment in CTD-ILD patients was mainly the reduction of carbon monoxide dispersion.2.For CTD patients,routine chest HRCT and pulmonary function tests are recommended to facilitate the early diagnosis and early treatment of CTD-ILD.3.HRCT score was related to lung function test,and HRCT can reflect the degree of lung function damage of patients to some extent.