原发性干燥综合征合并肺间质病变的临床特点分析

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目的:了解pSS合并肺间质病变(ILD)患者的临床及实验室特点。方法:回顾性分析北京大学第三医院收治的140例符合2002年美国-欧洲分类标准的pSS住院患者资料,根据呼吸系统症状和体格检查,结合肺部高分辨率CT确诊ILD,比较合并ILD组和未合并ILD组患者的临床及实验室特征。采用Mann-Whitney秩和检验、n χ2检验和Fisher确切概率法进行分析。n 结果:140例pSS患者中有32例合并ILD,总体发生率为22.9%(32/140)。与未合并ILD的患者相比,合并ILD的pSS患者的突出临床表现是咳嗽[分别为11.1%(12/108)、50.0%(16/32),n χ2=23.333,n P<0.05]和呼吸困难[分别为10.2%(11/108)、53.1%(17/32),n χ2=28.448,n P<0.05],就诊年龄[分别为(52±13)岁,(65±9)岁,n t=-6.077,n P<0.05]和发病年龄[分别为(45±15)岁,(58±11)岁,n t=-4.622,n P<0.05]较大,RF阳性率[分别为64.9%(63/97)、42.3%(11/26),n χ2=4.385,n P<0.05]、RF滴度[分别为(213±542)U/ml,(90±173)U/ml,n t=-2.128,n P<0.05]、抗SSA抗体阳性率[分别为81.1%(86/106)、51.6%(16/31),n χ2=10.988,n P<0.05]较低。n 结论:pSS合并ILD发生率较高,就诊年龄及发病年龄相对较大,RF及抗SSA抗体阳性率更低,但干燥相关表现差异无统计学意义。“,”Objective:To investigate the clinical and laboratory characteristics of patients with primary Sj?gren′s syndrome (pSS) complicated with interstitial lung disease (ILD).Methods:The clinical data of 140 patients with pSS who met the American-European classification criteria in 2002 were analyzed retrospectively. The diagnosis of ILD was confirmed by respiratory system symptoms and physical examination combined with high resolution CT of lung, the clinical and laboratory characteristics were compared between ILD group and non-ILD group. Statistical methods used were Mann-Whitney n U test, Chi-square test and Fisher exact probability.n Results:ILD was present in 32 of 140 patients with pSS, and the overall incidence was 22.9%. Compared with pSS without ILD, the prominent clinical features of pSS with ILD were cough [11.1%(12/108), 50.0%(16/32); respectively, n χ2=23.333, n P<0.05] and dyspnea [10.2%(11/108), 53.1%(17/32); respectively,n χ2=28.448, n P<0.05]. The age of visit [(52±13) years, (65±10) years; respectively,n t=-6.077, n P<0.05] and the age of onset [(45±15) years, (58±11) years; respectively,n t=-4.622, n P<0.05) were higher. The positivity of RF [64.9% (63/97) , 42.3% (11/26) ; respectively,n χ2=4.38, n P<0.05], RF titer [(213±542) U/ml, (90±173) U/ml, respectively,n t=-2.128, n P<0.05], and the positivity of anti-SSA antibody [81.1% (86/106) , 51.6% (16/31) ; respectively,n χ2=10.988, n P<0.05] were lower.n Conclusion:The incidence of ILD in pSS is relatively high, the age at visit and the age of onset are high, and the positive rates of RF and SSA antibody are low. There is no significant difference in the manifestations related to dryness.
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