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[系统性红斑狼疮中亚临床肺部受累的患病率升高]

[An elevated prevalence of subclinical pulmonary involvement in systemic lupus erythematosus].

作者信息

Bosch X, Agustí A G, Font J, Roca J, López-Soto A, Ingelmo M, Rodríguez-Roisín R

机构信息

Servicio de Medicina Interna General, Hospital Clínico y Provincial, Barcelona.

出版信息

Rev Clin Esp. 1991 Oct;189(5):203-8.

PMID:1801067
Abstract

Lung function was prospectively studied in a group of non-selected systemic lupus erythematosus (SLE) female patients who consecutively came to our Lung Function Laboratory. There was no previous history of smoking in any patient nor there was clinical and/or radiographic evidence of lung affectation prior to the diagnosis of SLE. Some respiratory lung function abnormalities were observed in 17 patients (65%). The most frequent functional anomaly was the alteration in carbon monoxide transfer (DLCO), which was present in 10 cases (38%). On the other hand, a restrictive ventilatory failure was observed in 8 patients (31%) and a obstructive ventilatory failure in 6 other (23%). Out of these, 3 patients (12% of the total number of cases) presented bronchial hyperreactivity, which could also be confirmed in a patient presenting a mixed ventilatory failure. Isolated air entrapment could be observed in 2 patients, which could indicate disfunction of small airways in these cases. There was no correlation between functional respiratory failure and clinical activity of SLE, duration of the disease, other organ involvement, treatment and/or serum antibodies. Given that a great number of these functional lung anomalies (42%) exist in the absence of any clinical and radiological anomalies and that an important subgroup of patients are responsive to bronchodilators, we consider that the systemic evaluation of lung function must be obliged in the clinical treatment of SLE patients.

摘要

我们对一组连续前来肺功能实验室的未经过挑选的系统性红斑狼疮(SLE)女性患者的肺功能进行了前瞻性研究。所有患者既往均无吸烟史,且在SLE诊断之前无肺部受累的临床和/或影像学证据。17例患者(65%)观察到一些呼吸肺功能异常。最常见的功能异常是一氧化碳弥散量(DLCO)改变,10例患者(38%)出现该情况。另一方面,8例患者(31%)观察到限制性通气功能衰竭,另外6例患者(23%)观察到阻塞性通气功能衰竭。其中,3例患者(占病例总数的12%)出现支气管高反应性,在1例出现混合性通气功能衰竭的患者中也得到证实。2例患者观察到单纯的气体潴留,这可能表明这些病例中小气道功能障碍。呼吸功能衰竭与SLE的临床活动度、病程、其他器官受累情况、治疗和/或血清抗体之间无相关性。鉴于大量这些肺功能异常(42%)在无任何临床和影像学异常的情况下存在,且有一个重要的患者亚组对支气管扩张剂有反应,我们认为在SLE患者的临床治疗中必须对肺功能进行系统评估。

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