Strevens Bolmgren Victor, Olsson Peter, Wollmer Per, Hesselstrand Roger, Mandl Thomas
Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
Department of Rheumatology, Skåne University Hospital, IM Nilssons gata 32, 205 02, Malmö, Sweden.
Rheumatol Int. 2017 May;37(5):813-818. doi: 10.1007/s00296-017-3678-5. Epub 2017 Feb 27.
Involvement of the respiratory system, in particular dry airways and chronic obstructive pulmonary disease (COPD), is common in patients with primary Sjögren's syndrome (pSS). As respiratory symptoms are also common in pSS patients and may have different etiologies, we wanted to evaluate the amount and impact of respiratory symptoms in out-patients with pSS and to assess if such symptoms are related to concomitant COPD. The St George's Respiratory Questionnaire (SGRQ) was used to assess respiratory symptoms. SGRQ scores were compared between 51 consecutive pSS patients, in an out-patient setting, and 80 population-based controls. The patients were also studied by pulmonary function tests and CT scans of the lungs to assess signs of obstructive airway disease, including COPD, as well as to assess signs of interstitial lung disease (ILD). 41 and 18% of pSS patients were found to have COPD and radiographic signs of ILD, respectively. pSS patients had significantly higher SGRQ scores compared to controls, but no significant differences in SGRQ scores were found between patients with and without COPD. Neither did the small group of pSS patients with ILD significantly differ in SGRQ scores in comparison to patients without ILD. Respiratory symptoms were common in pSS, but were not more common in patients with concomitant COPD. Since pulmonary involvement in pSS is associated with an increased mortality and respiratory symptoms is a poor marker for pulmonary involvement, we suggest that pulmonary function tests should be performed liberally in all pSS patients regardless of symptoms.
原发性干燥综合征（pSS）患者常累及呼吸系统，尤其是气道干燥和慢性阻塞性肺疾病（COPD）。由于呼吸系统症状在pSS患者中也很常见且可能病因各异，我们希望评估pSS门诊患者呼吸系统症状的数量和影响，并评估这些症状是否与合并的COPD相关。采用圣乔治呼吸问卷（SGRQ）评估呼吸系统症状。比较了51例连续门诊pSS患者与80例基于人群的对照者的SGRQ评分。还通过肺功能测试和肺部CT扫描对患者进行研究，以评估阻塞性气道疾病（包括COPD）的体征以及间质性肺疾病（ILD）的体征。分别有41%和18%的pSS患者被发现患有COPD和ILD的影像学表现。与对照组相比，pSS患者的SGRQ评分显著更高，但有COPD和无COPD的患者之间SGRQ评分无显著差异。一小部分有ILD的pSS患者与无ILD的患者相比，SGRQ评分也无显著差异。呼吸系统症状在pSS中很常见，但合并COPD的患者中并不更常见。由于pSS的肺部受累与死亡率增加相关，且呼吸系统症状并不是肺部受累的良好指标，我们建议无论有无症状，所有pSS患者都应广泛进行肺功能测试。
