Department of Respiratory Medicine, Fukui University Hospital, 23 Shimoaizuki, Eiheizi-cho, Fukui 910 1193, Japan.
Respir Med. 2011 Dec;105(12):1931-8. doi: 10.1016/j.rmed.2011.08.009. Epub 2011 Sep 7.
Relationships among clinical, physiological, imaging and pathological findings of small airway disease associated with Sjögren's syndrome have remained unclear.
We retrospectively studied 14 patients who underwent surgical lung biopsy and who were diagnosed with small airway disease associated with primary or secondary Sjögren's syndrome. We compared clinical, bronchoalveolar lavage, physiological, imaging and pathological findings between primary and secondary Sjögren's syndrome. We scored HRCT and pathological abnormalities and investigated correlations among physiological, HRCT and pathological data, changes in physiological parameters and in HRCT scores after two years of treatment, as well as correlations between these values and pathological scores.
Bronchoalveolar lavage fluid, physiological, imaging and pathological findings of the airways did not significantly differ between primary and secondary Sjögren's syndrome. Air trapping on HRCT negatively correlated with MEF50 and MEF25. Although lymphoid cell infiltration and peribronchiolar fibrosis were the most common pathologies, constrictive change scores correlated negatively with MEF50 and MEF25, positively with air trapping scores and negatively with improvements after therapy in MEF(50), MEF(25) and air trapping.
Constrictive change was the most significant determinant of physiological and imaging presentations and of changes in these factors after therapy for small airway disease associated with Sjögren's syndrome.
干燥综合征相关小气道疾病的临床、生理、影像和病理学表现之间的关系仍不清楚。
我们回顾性研究了 14 名接受了外科肺活检并被诊断为原发性或继发性干燥综合征相关小气道疾病的患者。我们比较了原发性和继发性干燥综合征的临床、支气管肺泡灌洗、生理、影像和病理学表现。我们对 HRCT 和病理学异常进行评分，并研究了生理、HRCT 和病理学数据之间的相关性、两年治疗后生理参数和 HRCT 评分的变化，以及这些值与病理学评分之间的相关性。
原发性和继发性干燥综合征的支气管肺泡灌洗液、气道生理和影像学表现无显著差异。HRCT 上的空气潴留与 MEF50 和 MEF25 呈负相关。虽然淋巴样细胞浸润和细支气管周围纤维化是最常见的病理改变，但缩窄性改变评分与 MEF50 和 MEF25 呈负相关，与空气潴留评分呈正相关，与治疗后 MEF(50)、MEF(25)和空气潴留的改善呈负相关。
缩窄性改变是干燥综合征相关小气道疾病的生理和影像学表现以及这些因素在治疗后的变化的最重要决定因素。
