原发性干燥综合征合并肺间质病变临床特点分析

Clinical analysis of primary Sjgren syndrome combined with interstitial lung disease

目的探讨原发性干燥综合征(PSS)合并间质性肺疾病(ILD)的临床特征及治疗转归。方法 87例PSS患者根据是否合并ILD分为ILD组24例和无ILD组63例,分别对其发病时间、病程、实验室检查、影像学检查及治疗和预后情况进行回顾性分析。结果 ILD组年龄大于无ILD组,且病程长于无I LD组,差异有统计学意义(P<0.05);ILD组ESR、CRP水平及RF、抗SSA抗体、高球蛋白血症、抗U1 RNP抗体的阳性率均明显高于无ILD组(P<0.05)。ILD组患者肺高分辨率CT(HRCT)检查均存在异常,均予糖皮质激素及免疫抑制剂环磷酰胺治疗6个月,20例患者临床症状和(或)肺功能有不同程度的改善,2例无改善,2例病情进展。结论对PSS早期行肺HRCT检查和早期规范治疗,有助于提高其并发ILD的诊断和改善预后。

Objective To investigate the clinical characteristics,treatment and prognosis of primary Sj（u｜）gren syndrome （PSS） combined with interstitial lung disease（ILD）.Methods 84 patients with PSS were divided into two groups （ILD group：n=24,non-ILD group：n=63）.Retrospective analysis were carried out according to the time of onset,clinical course,laboratory test,imaging examination and condition of treatment and prognosis in the two groups separately.Results The age of onset and courses of disease in ILD group were elder and longer than patients in non-ILD group（P0.05）.The ESR,CRP level and RF,anti SSA antibodies,plasma protein,anti U1RNP antibody positive rales in the ILD group were significantly higher than those in non-ILD group（P0.05）.Patients in ILD group had abnormal pulmonary HRCT results.All of the patients in ILD group were given corticosteroid and immunosuppressant cyclophosphamide therapy for 6 months.Clinical symptoms and / or pulmonary function were improved with different degrees in 20 patients,no improvement were found in 2 cases and progressive in 2 cases.Conclusion Pulmonary HRCT is useful in the early diagnosis of PSS combined with interstitial lung disease.Early stage standardized treatment is helpful for the improvement of prognosis.