目的对结缔组织病(CTD)合并肺栓塞患者的临床资料进行分析,以期指导临床早期诊断和治疗。方法回顾性分析2013年1月—2014年12月杭州邵逸夫医院及宁波市第一医院CTD合并肺栓塞13例患者的临床表现、影像学改变、治疗及预后。结果 13例CTD患者中类风湿性关节炎4例;系统性红斑狼疮3例;干燥综合征3例;原发性抗磷脂综合征1例,自身免疫性溶血性贫血合并抗磷脂综合征1例;风湿性多肌痛1例。13例患者中出现呼吸困难9例,胸痛6例,咯血与发热均为4例。5例患者有下肢浮肿,其中2例为单侧下肢浮肿。11例患者行CT肺动脉造影(CTPA)检查,其中1例为肺动脉主干充盈缺损,2例为叶及以下肺动脉充盈缺损,其他8例患者为段及以下肺动脉充盈缺损。5例患者行放射性核素肺通气/血流灌注(V/Q)检查,均表现为段及以下放射性稀疏缺损区与肺通气显像不匹配。除肺血管病变,13例患者中有12例存在其他肺部影像学改变,其中渗出表现5例,纤维条索灶4例,支气管扩张4例,间质性改变2例,胸腔积液或胸膜增厚6例。13例患者均进行了经胸心脏彩超检查,其中6例出现轻到重度肺动脉高压。12例患者进行了下肢静脉彩超检查,发现5例存在下肢深静脉血栓形成,1例存在浅静脉血栓形成。13例患者均接受了抗凝治疗,30天全因死亡率为0。结论 CTD患者出现新发呼吸困难等症状或胸部影像改变需警惕肺栓塞。 Objective To analyze the clinical data of patients with connective tissue disease (CTD) complicated with pulmonary embolism in order to guide the clinical diagnosis and treatment. Methods The clinical manifestations, imaging changes, treatment and prognosis of 13 patients with CTD complicated with pulmonary embolism at Run Run Shaw Hospital and Ningbo First Hospital from January 2013 to December 2014 were retrospectively analyzed. Results Thirteen patients with CTD had rheumatoid arthritis in 4 cases, 3 cases with systemic lupus erythematosus, 3 cases with Sjogren’s syndrome, 1 case with primary antiphospholipid syndrome, 1 case with autoimmune hemolytic anemia combined with antiphospholipid syndrome Rheumatic polymyalgia in 1 case. Thirteen patients had dyspnea in 9, chest pain in 6, and hemoptysis and fever in 4. Five patients had lower extremity edema, two of which were unilateral lower extremity edema. Eleven patients underwent CT pulmonary angiography (CTPA), of which 1 was filled with defects of the pulmonary artery trunk, 2 were filled with defects of the pulmonary artery below the leaf and below, and 8 were filled with defects of the pulmonary artery in the segment and below. Five patients underwent radionuclide pulmonary ventilation / perfusion (V / Q) examination, both showed segments and below the radioactive sparse defect area and pulmonary ventilation imaging does not match. In addition to pulmonary vascular disease, 12 of the 13 patients had other lung imaging changes, including 5 cases of exudation, 4 cases of fibrous stalk, 4 cases of bronchiectasis, 2 cases of interstitial changes, pleural effusion or Pleural thickening in 6 cases. Thirteen patients underwent transthoracic echocardiography, of which 6 cases had mild to severe pulmonary hypertension. 12 patients underwent venous ultrasonography, found in 5 cases of lower extremity deep vein thrombosis, 1 case of superficial vein thrombosis. Thirteen patients received anticoagulation and all-cause mortality was zero at 30 days. Conclusions CTD patients should be alert to pulmonary embolism if they have symptoms such as newly developed dyspnea or changes in their chest images.