原发性干燥综合征合并肺间质病变的临床分析

Clinical analysis of primary Sjogren′s syndrome with interstitial lung disease

目的探讨原发性干燥综合征(PSS)肺间质病变(ILD)的临床特点。方法回顾性分析79例PSS患者临床及实验室资料。其中,合并ILD 40例(ILD组),非ILD患者39例(非ILD组)。结果 ILD组C反应蛋白[(22.53±29.44)mg/L vs.(12.99±26.45)mg/L]、补体C3[(0.92±0.34)g/L vs.(0.87±0.68)g/L]、补体C4[(0.26±0.08)g/L vs.(0.21±0.07)g/L]均明显高于非ILD组(P<0.05或P<0.01)。ILD组肺功能检查主要表现为弥散功能减低和限制性通气功能障碍;高分辨率CT(HRCT)检查在发现PSS-ILD的敏感性优于普通X线片。治疗后,ILD组中36例临床症状明显缓解;2例合并肺部感染,呼吸衰竭死亡。结论 PSS-ILD的发生与疾病活动性和严重性相关。HRCT检查有助于早期发现PSS-ILD病变。

Objective To analyze the clinical characteristics of primary Sjogren′s syndrome and interstitial lung disease （PSS-ILD）.Methods Data of 79 PSS cases were retrospectively analyzed,of whom 40 patients were with ILD（group A） and 39 patients without（group B）.Results C-reactive protein was higher in group A than that in group B [（22.53±29.44）mg/L vs.（12.99±26.45）mg/L]（P0.05）.So did complement C3[（0.92±0.34）g/L vs.（0.87±0.68）g/L]（P0.05） and complement C4[（0.26±0.08）g/L vs.（0.21±0.07）g/L]（P0.01）.Pulmonary function tests in group A showed reduced diffusing capacity and restrictive ventilatory dysfunction.HRCT was more sensitive in detecting PSS-ILD than conventional X-ray examination.After treatment in group A,remarkable remission was seen in 36 of 40 cases,two cases associated with pulmonary infection died from respiratory failure.Conclusion PSS-ILD is related to the severity and activity of the disease.HRCT scan is useful in early diagnosis of the disease.