继发于干燥综合征的间质性肺病21例临床分析

A clinical analysis of 21 patients with interstitial lung disease complicated by Sjogren's syndrome

目的探讨继发于干燥综合征(Sjogren′s syndrome,SS)的间质性肺病(interstitial lung disease ILD)的诊断治疗方法。方法对21例继发于SS的ILD患者的临床表现、肺部X线、HRCT、肺功能、实验室检查及治疗情分析。结果本组继发于SS的ILD患者的主要临床症状为咳嗽、气促。肺部HRCT主要表现为肺容积缩小、网格影、毛玻璃影、胸膜下小叶间隔增厚、胸膜下弧线影、牵拉性小支气管扩张、胸膜增厚粘连,在诊断方面优于胸部X线。肺功能检测异常主要为弥散功能降低和限制性通气障碍。实验室检查多见血沉增快,自身抗体阳性,免疫球蛋白升高。经糖皮质激素单用或联合细胞毒性药物治疗,临床症状有改善。结论继发于SS的ILD的诊断主要包括:临床表现、肺功能、肺部影像学、相关实验室检查。糖皮质激素和细胞毒性药物对继发于SS的ILD患者有良好疗效。

Objective To investigate the clinical features, diagnose and therapy of interstitial lung disease（ILD） complicated by sjogren＇s syndrome（SS）. Methods The data of 21 cases were analyzed of clinical features, chest X radiograph,chest high resolution computer tomography （HRCT） ,lung function, and results of breadboard examination, therapy of 21 cases complicated by SS. Results Major clinical manifestations of patients were cough and breathlessness. The major manifestation of lung HRCT were lung volume deflating, reticular changing,ground-glass opacities, interlobular septal under membrane pleural thickening, linear parenchymal opacities, dragged bronchi- ectasis, and membrane pleural thickening and adhering. Lung HRCT surpassed chest X radiograph in diagnosing ILD. The impairment of lung function was the decreased DLco and restricted ventilatory function abnormalities. We frequently observed antoantibody and increasing of blood sedimentation and immunoglobulin in laboratory examination. Symptoms of the patients improved through therapy of only glucocor- ticoid or associating cytotoxic drug. Conclusion Clinical manifestation, lung function, and lung imageology had important value to diagnosing ILD complicated by SS. Glucocorticoid or associating cytotoxic drug is effective in treating ILD complicated by SS.