Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Respir Med. 2018 Apr;137:95-102. doi: 10.1016/j.rmed.2018.02.023. Epub 2018 Mar 1.
Although high-resolution computed tomography (HRCT) is useful for the characterization of minute morphological changes in the lungs, no study has investigated risk factors for lung involvement detected by HRCT in patients with Sjögren's syndrome with or without respiratory symptoms. The aim of the current study was to investigate risk factors for lung involvement in patients with primary Sjögren's syndrome detected by HRCT, with a particular focus on airway and interstitial lung diseases.
We performed a retrospective cohort study of patients with primary Sjögren's syndrome and investigated risk factors for lung involvement detected by HRCT. A total of 101 patients with primary Sjögren's syndrome with initial HRCT examinations were enrolled.
Higher age, dry mouth, and higher labial gland biopsy focus scores (≥4) were risk factors for airway diseases (odds ratio [OR] 1.064 confidence interval [CI] 1.026-1.102, OR 8.795 CI 2.317-33.378 and OR 3.261 CI 1.100-9.675, respectively) in the multivariable analysis. Higher age, male sex, and higher labial gland biopsy focus scores (≥4) were risk factors for interstitial lung diseases (OR 1.078 CI 1.032-1.127, OR 12.178 CI 1.121-132.307 and OR 3.954 CI 1.423-10.987, respectively) in the multivariable analysis. The presence of anti-T-lymphotropic virus type 1 antibodies was significantly more common in patients with airway diseases.
This study showed significant associations of labial gland biopsy focus scores and dry mouth with pulmonary manifestations in patients with primary Sjögren's syndrome. Focus scores as well as dry mouth may reflect lymphoproliferative activity in the lungs in patients with primary Sjögren's syndrome.
尽管高分辨率计算机断层扫描（HRCT）有助于描述肺部的微小形态变化，但尚无研究调查有无呼吸道症状的干燥综合征患者的 HRCT 检测到的肺部受累的危险因素。本研究旨在探讨原发性干燥综合征患者 HRCT 检测到的肺部受累的危险因素，尤其关注气道和间质性肺疾病。
我们对原发性干燥综合征患者进行了回顾性队列研究，并调查了 HRCT 检测到的肺部受累的危险因素。共纳入 101 例原发性干燥综合征患者，进行了初始 HRCT 检查。
多变量分析显示，年龄较大、口干和唇腺活检焦点评分较高（≥4）是气道疾病（比值比[OR] 1.064，置信区间[CI] 1.026-1.102，OR 8.795，CI 2.317-33.378 和 OR 3.261，CI 1.100-9.675）的危险因素。年龄较大、男性和唇腺活检焦点评分较高（≥4）是间质性肺疾病的危险因素（OR 1.078，CI 1.032-1.127，OR 12.178，CI 1.121-132.307 和 OR 3.954，CI 1.423-10.987）。气道疾病患者中抗 T 淋巴细胞病毒 1 型抗体的存在明显更为常见。
本研究表明，唇腺活检焦点评分和口干与原发性干燥综合征患者的肺部表现存在显著关联。焦点评分和口干可能反映了原发性干燥综合征患者肺部的淋巴增生活性。
