CTD-ILD, i.e. IMTCT, is a serious complication associated with the CTD. The following is a detailed description of their diagnosis and treatment:
I. Diagnosis
Clinical performance
CTD-ILD patients may exhibit double symptoms of CTD and ILD. The common symptoms of CTD include heat, wasting, joint pain, morning stiffness, dry mouth, rashes, muscle pains, muscle incapacities and the Reno phenomenon. The ILD-related symptoms are mainly in the form of dry cough, chest suffocation, short post-motion air, hair perfunction, and hearing and pulmonary decomposition (Velcro accent).
Auxiliary examination
High resolution CT (HRCT) chest: is an important means of diagnosing ILD. The HRCT is able to clearly identify the internal structure of the lungs and help to detect early ILD pathologies in which symptoms are hidden. CTD-ILD may be shown on the HRCT in the form of double-down pulmonary symmetry, meso-tongue pulmonary disease in the lower pleural zone.
Pulmonary function examination: includes indicators such as pressure pulmonary activity (FVC), total lung (TCL) and carbon monoxide (DLco) to assess a patient ‘ s lung function. ILD patients usually suffer from restricted ventilation and dispersive functional disorders.
Serum markers: KL-6, CC16, etc., may be significantly higher in ILD patients and assist in supporting diagnosis.
BALF examination: Although its cytological significance for ILD diagnosis and prognosis remains widely contested, it remains an important means of identifying diagnostics.
Pulmonary biopsy: There is a certain risk for creative examinations. However, when a visual examination does not determine the type of disease or the patient ‘ s condition is not extreme, the pulmonary activity examination may help to identify the pathology type, understand the pulmonary stress and make a prognosis. However, pulmonary biopsy is not usually performed if video-testing can determine the type of disease and the patient is at two extremes, light or heavy.
Diagnostic criteria
There are currently no accepted diagnostic criteria, but CTD-related ILDs are usually identified with lung infections, tumours, drugs and other inter-pulmonary pathologies caused by other diseases such as pulmonary infections, tumours, drugs and allergies, in conjunction with medical history inquiries, videotography, swirling or BALF examinations, and even pulmonary tissue biopsy. The CTD-ILD diagnostic criteria are based on a combination of clinical performance, ancillary examinations and multidisciplinary discussions. It should be noted that, given the heterogeneity of the CTD-ILD, the clinical performance of different patients and the results of supplementary examinations may vary, so that the diagnosis needs to be considered in a holistic manner, taking into account the specific circumstances of the patient. At the same time, the CTD-ILD diagnostic standards are likely to be updated and refined as medical technology progresses and new diagnostic methods emerge.
Treatment
Treatment target
The aim is to delay the patient ‘ s clinical deterioration, eventually extending the patient ‘ s life and improving the quality of life.
Treatment programme
Precinct treatment: treatment of precidental cases of concubine tissue disease to control progress.
Anti-fibrosis treatment: Anti-fibrosis treatment for ILD to reduce lung fibrosis.
Drug treatment: mainly hormonal and/or immunosuppressants. Specific drug choices and dosages need to be adjusted to the patient ‘ s condition and tolerance.
Assistive treatment: including smoking, drinking, nutritionally balanced diet, keeping indoor air clean and clean, and avoiding infection. Particular attention is paid to preventing infection for those who use hormones and/or immunosuppressants.
Multidisciplinary discussions (MDT)
CTD-ILD consultations require multidisciplinary discussions among physicians such as respiratory, rheumatological, video and pathology. Through MDT, individualized treatment programmes can be developed that take into account the clinical performance of patients, the results of supplementary examinations and the individual situation.
Follow-up and monitoring
During treatment, care should be taken on a regular basis to monitor common combinations of infections, aneurysms, pulmonary arteries and respiratory failure. The frequency of follow-up visits varies depending on the progress of the disease. At the same time, the effectiveness and progress of treatment are regularly assessed and treatment programmes are adjusted in a timely manner.
In the light of the above, the diagnosis and treatment of CTD-ILD needs to take into account the clinical performance of the patient, the results of the secondary examinations and the individual situation. Early diagnosis and active treatment can slow progress and improve the quality of life of patients. At the same time, patients are required to actively cooperate with the doctor ‘ s recommendations for treatment, and to conduct regular follow-up and management.
