Abdulla Eiman, Al-Zakwani Ibrahim, Baddar Sawsan, Abdwani Reem
Oman Med J. 2012 Jan;27(1):36-9. doi: 10.5001/omj.2012.07.
The aim of this study was to investigate the frequency of pulmonary function abnormalities in clinically asymptomatic children with Systemic Lupus Erythematosus and to determine the relationship of these abnormalities to clinical, laboratory, and immunological parameters as well as to disease activity.
Forty-two children with childhood onset Systemic Lupus Erythematosus were included in this study. Demographic, clinical, laboratory and immunological parameters, as well as disease activity were assessed. Pulmonary function tests (PFT) were performed routinely to screen for subclinical lung disease.
Out of the 42 children, 19% (n=8) had clinical evidence of pulmonary involvement. The patients with no clinical evidence of pulmonary involvement (n=34) represent the study cohort. From our cohort of patients with no clinical evidence of pulmonary involvement 79% (n=27) had PFT abnormality; including 62% (n=21) had reduced FVC, 71% (n=24) had reduced FEV1, and 67% (n=12) had reduced DLCO. Similarly, 56% (n=15) had a restrictive PFT pattern, and 2.6% (n=2) had an obstructive PFT pattern, while 33% (n=7) had an isolated impairment of diffusion capacity. Due to small sample size; it was not possible to find a statistically significant difference between the cohort of asymptomatic SLE patients with abnormal PFT findings (n=27) and those with normal PFT findings (n=7) in terms of clinical, laboratory, immunological or disease activity index score.
Subclinical lung disease, as demonstrated by abnormal PFT in patients with normal radiographs, may be common but should be interpreted with caution as an early sign of lung disease. Although PFT studies do not correlate well with pulmonary symptoms in patients with childhood onset SLE, they nevertheless provide objective quantification of the type and severity of the functional lesions.
本研究旨在调查临床无症状的系统性红斑狼疮患儿肺功能异常的发生率，并确定这些异常与临床、实验室、免疫参数以及疾病活动度之间的关系。
本研究纳入了42例儿童期起病的系统性红斑狼疮患儿。评估了人口统计学、临床、实验室和免疫参数以及疾病活动度。常规进行肺功能测试（PFT）以筛查亚临床肺部疾病。
42例患儿中，19%（n = 8）有肺部受累的临床证据。无肺部受累临床证据的患者（n = 34）构成研究队列。在我们无肺部受累临床证据的患者队列中，79%（n = 27）存在PFT异常；其中62%（n = 21）的用力肺活量（FVC）降低，71%（n = 24）的第一秒用力呼气容积（FEV1）降低，67%（n = 12）的一氧化碳弥散量（DLCO）降低。同样，56%（n = 15）呈现限制性PFT模式，2.6%（n = 2）呈现阻塞性PFT模式，而33%（n = 7）仅有弥散功能受损。由于样本量小，在PFT结果异常的无症状SLE患者队列（n = 27）和PFT结果正常的患者队列（n = 7）之间，就临床、实验室、免疫或疾病活动指数评分而言，未能发现统计学上的显著差异。
胸部X线片正常的患者PFT异常所显示的亚临床肺部疾病可能很常见，但作为肺部疾病的早期征象应谨慎解读。虽然PFT研究与儿童期起病的SLE患者的肺部症状相关性不佳，但它们仍能对功能性病变的类型和严重程度提供客观量化。
