原发性干燥综合征的肺部改变

Pulmonary manifestation in primary Sjgren′s syndrome

目的 了解原发性干燥综合征 (pSS)的肺部损害。方法 选择 4 3例病人和 2 0例正常者或骨关节炎患者 ,进行了临床、放射学及肺功能的观察。结果 3 8例 ( 88 4 % ) pSS患者肺受累 ,其中 15例 ( 3 4 9% )为小气道损害 ,2 3例 pSS患者残气量 /总气量≥ 8,为高肺含气量 ,其 2 5 %肺活量最大呼气流量 (V ·0 2 5) ,5 0 %肺活量最大呼气流量 (V ·0 50 )较非高含气量组明显降低 (P <0 0 5 ) ,其呼吸困难也较明显 (P <0 0 5 )。 19例胸片及 1例高分辨率CT示肺间质损害 ,与肺功能及临床症状无平行关系。结论 pSS的系统损害中 ,肺脏特别是小气道是常见的靶器官 ,肺高含气量与小气道功能下降有关。

Objective To evaluate pulmonary findings in patients with primary Sjgren′s syndrome (pSS).Methods Forty three patients with pSS and 20 age and sex matched control subjects were evaluated by clinical,roentgenologic and lung functional observation.Results Thirty eight patients with pSS (88 4%) had evidence of respiratory involvement.Small airway disease was most common (34 9%).Pulmonary hyperinflation (residual volume/total lung capacity ≥8) was observed in 23 (53 5%) patients.Patients with pSS with hyperinflation had significantly lower maximal expiratory flow V · 0 25 ( P <0 05), V · 0 50 ( P <0 05) and more frequently dyspnea.Twenty patients with pSS had interstitial lung disease on radiographs but did not correlate with functional and clinical findings.Conclusion Lung involvement,especially small airway may be a usual target organ in pSS.Pulmonary hyperinflation associated with diminished peripheral spirometric flow values.