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目的探讨结缔组织病(CTD)患者肺功能尤其是肺弥散功能的损伤情况及其与病程时间的关系;分析肺功能检测对于CTD肺部疾病的临床意义。方法对我院风湿免疫科已确诊CTD的71例患者进行肺通气功能及弥散功能检测,并与正常组比较。结果 80.00%CTD患者存在肺功能的异常,主要以弥散功能下降为主,其次为肺容积的减少、气道阻塞等。肺功能各项指标的异常率(DLCO)为71.83%,DLCO/肺泡通气量(VA)为31.00%,用力肺活量(FVC)为36.62%,慢肺活量(SVC)为31.00%,1秒用力呼气容积(FEV1)为29.58%,FEV1/FVC为5.60%,VA为69.01%,最大呼气流速(FEFmax)为12.68%,小气道功能(FEF)25%～75%为35.21%。结论 CTD患者肺功能损害主要以肺弥散功能为主,并伴有肺容量的减低等。肺功能检查较肺部CT更早出现异常,对CTD患者肺部疾病的早期发现、治疗及预防有很好的临床意义。
Objective To investigate the damage of lung function, especially pulmonary diffuse function in patients with connective tissue disease (CTD) and its relationship with duration of disease. To analyze the clinical significance of lung function test in CTD pulmonary disease. Methods A total of 71 patients with confirmed CTD from our department of rheumatology were tested for pulmonary ventilation and diffusing ability, and compared with normal group. Results 80.00% CTD patients had abnormal pulmonary function, mainly in the decline of diffuse function, followed by the reduction of lung volume, airway obstruction and so on. The DLCO was 71.83%, DLCO / VA was 31.00%, FVC was 36.62%, SVC was 31.00%, forced expiration was 1 second (FEV1) of 29.58%, FEV1 / FVC of 5.60%, VA of 69.01%, maximum expiratory flow (FEFmax) of 12.68% and small airway function (FEF) of 25% to 75% of 35.21%. Conclusions Pulmonary dysfunction in patients with CTD is dominated by pulmonary diffuse function, accompanied by decreased lung capacity. Lung function tests earlier than lung CT abnormalities, early detection, treatment and prevention of pulmonary disease in patients with CTD have very good clinical significance.