原发性干燥综合征合并间质性肺疾病的临床特点及影响因素分析

Clinical Characteristics and Influencing Factors of Primary Sj gren Syndrome Complicated with Interstitial Lung Disease

目的探讨原发性干燥综合征合并间质性肺疾病(PSS-ILD)的临床、实验室、影像学特点及危险因素。方法将郑州大学第一附属医院2016年1月至2019年12月收治的68例PSS-ILD患者纳入PSS-ILD组,将同期住院的69例PSS患者纳入对照组。回顾性分析两组患者一般资料、临床症状、实验室检查结果、肺部高分辨率CT检查结果等资料,采用多因素二元logistic回归分析PSS合并ILD的影响因素。结果PSS-ILD组发病年龄大于PSS组,且发病年龄≥65岁的患者占比更高,差异有统计学意义(P<0.05)。PSS-ILD患者白细胞计数(WBC)、中性粒细胞计数(N)、补体C3、补体C4水平高于PSS组(P<0.05)。PSS-ILD患者抗SSA抗体和抗β2糖蛋白1抗体阳性率低于PSS组(P<0.05)。PSS-ILD患者咳嗽、咳痰、胸闷、气喘发生率高于PSS组,口干、眼干、关节肿痛发生率低于PSS组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,发病年龄≥65岁是PSS-ILD的独立危险因素(OR=5.033,P<0.05)。结论PSS-ILD患者发病年龄较大,WBC、N、补体C3、补体C4水平较高,更易出现咳嗽、咳痰、胸闷、气喘等症状,发病年龄大可能是其独立危险因素。

Objective To investigate the clinical,laboratory,imaging characteristics and risk factors of primary Sj gren syndrome with interstitial lung disease(PSS-ILD).Methods A total of 68 PSS-ILD patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2019 were included in PSS-ILD group,and 69 PSS patients hospitalized during the same period were included in control group.General information,clinical symptoms,laboratory examination results,and lung high-resolution CT examination results of the two groups of patients were retrospectively analyzed.Multivariate logistic regression was used to analyze the influencing factors of PSS combined with ILD.Results The age of onset in PSS-ILD group was higher than that in PSS group(P<0.05),and the proportion of patients with the age of onset≥65 years old was higher in PSS-ILD group(P<0.05).The white blood cell(WBC),neutrophil(N),complement C3,and complement C4 levels in PSS-ILD group were higher than those in PSS group(P<0.05).The positive rate of anti-SSA antibody and anti-β2 glycoprotein 1 antibody in PSS-ILD group were lower than those in PSS group(P<0.05).The incidences of cough,sputum,chest tightness,and asthma in PSS-ILD group were higher than those in PSS group(P<0.05),and the incidences of dry mouth,dry eyes,and joint swelling and pain were lower than those in PSS group(P<0.05).Multivariate logistic regression analysis showed that the age of onset≥65 years was an independent risk factor for PSS-ILD(OR=5.033,P<0.05).Conclusion Patients with PSS-ILD have an older age of onset,higher levels of WBC,N,complement C3,and complement C4,and are more likely to have symptoms such as cough,sputum,chest tightness,and asthma.The older age of onset may be an independent risk factor of PSS-ILD.