系统性硬化症患者静息肺功能的变化

Observation of Static Lung Functions in Systemic Sclerosis

目的 :比较分析系统性硬化症 (SSc)患者有、无呼吸道症状等不同状态时静息肺功能的变化 ,以观察其不同阶段肺损害的程度。方法 :选择临床确诊的SSc患者 6 8例 ,测定静息肺功能的变化。结果 :无任何呼吸道症状组胸片异常占2 3 .2 % ,弥散功能障碍高达 91.1% ,限制型通气功能障碍占 42 .3 % ,小气道功能障碍占 5 6 .8%。有呼吸道症状组胸片异常占6 6 .7%。无呼吸道症状组和胸片正常组SSc患者实测值占预计值的百分比中均有 2项均值 (FEF2 5%～ 75% 和DLCSO)异常 ,而有呼吸道症状组和胸片异常组则分别有 5项异常。四组均以DLCO、FEF2 5%～ 75% 和PEF下降的发生率和下降幅度最大。各组FEV1/FVC均在正常范围内。结论 :SSc肺功能改变与呼吸系统症状和胸片异常改变有关 ,且早于呼吸系统症状出现和胸片异常改变前。弥散功能障碍和小气道病变是SSc早期的肺功能改变。

Objective: To observe changes of static lung functions in patients with systemic sclerosis (SSc) under different conditions . Methods: Static lung functions were measured by a spirometer in 68 patients with SSc. Results: In the respiratory symptom free SSc group, 23.2% patients have abnormal chest films; 91.1% have diffusing capacity dysfunction; 42.3% have restrictive ventilation dysfunction; and 56.8% have small airway dysfunction. In the respiratory symptom SSc group, 66.7% have abnormal chest films. Two lung function indexes were abnormal both in the respiratory symptom free group and in the normal chest film group. DL CO , FEF 25%～75% and PEF decreased significantly in all patients. VC, TLC, FRC and DL CO in the normal chest film group were higher than those in the abnormal group, respectively. Conclusion: The changes of lung functions in SSc closely correlated to respiratory symptoms and X ray films. Dysfunction of diffusing capacity and small airway were the earliest changes of lung functions in SSc.