Viegi G, Fornai E, Ferri C, Di Munno O, Begliomini E, Vitali C, Melocchi F, Bombardieri S, Paoletti P
CNR Institute of Clinical Physiology, University of Pisa, Italy.
Clin Rheumatol. 1989 Sep;8(3):331-8. doi: 10.1007/BF02030345.
Lung involvement in essential mixed cryoglobulinemia (EMC) has been recently described. In order to assess whether patients with EMC experience an accelerated deterioration of lung function, nineteen patients (17 females, 2 males; 49.6 +/- 6.6 years) underwent a short-term follow-up of lung function, chest X-ray and serologic investigations. Reduction of forced expiratory flows and presence of roentgenologic signs of interstitial involvement were confirmed in the baseline evaluation. In addition, a decrease of diffusing capacity was shown. After a mean interval of 15 months, no significant change in lung function was found, with the exception of decrease in maximal expiratory flow at 50% of forced vital capacity, total lung capacity, functional residual capacity, coefficient of transfer of CO. A slight decrease of hemolitic complement (CH50) and of complement fraction (C3) was also observed. This study suggests that patients with EMC tend to have an involvement of pulmonary interstitial space, possibly related to immune complex deposition, but they do not show a severe decline of lung function. Periodical assessment of lung function and chest X-ray is, however, worthwhile.
近期已有关于原发性混合性冷球蛋白血症(EMC)肺部受累的报道。为评估EMC患者的肺功能是否会加速恶化,对19例患者(17例女性,2例男性;年龄49.6±6.6岁)进行了肺功能、胸部X线及血清学检查的短期随访。在基线评估中证实存在用力呼气流量降低及间质性病变的放射学征象。此外,还显示出弥散能力下降。平均间隔15个月后,除用力肺活量50%时的最大呼气流量、肺总量、功能残气量、一氧化碳转运系数降低外,肺功能未发现显著变化。还观察到溶血补体(CH50)和补体成分(C3)略有下降。本研究提示,EMC患者往往存在肺间质受累,可能与免疫复合物沉积有关,但未表现出严重的肺功能下降。然而,定期评估肺功能和胸部X线是有必要的。