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系统性红斑狼疮和干燥综合征的肺部表现。

Pulmonary manifestations of systemic lupus erythematosus and Sjögren's syndrome.

机构信息

Department of Internal Medicine.

Department of Pulmonary and Critical Care Medicine, Cleveland Clinic, Cleveland, Ohio, USA.

出版信息

Curr Opin Rheumatol. 2018 Sep;30(5):449-464. doi: 10.1097/BOR.0000000000000531.

Abstract

PURPOSE OF REVIEW

Systemic lupus erythematosus (SLE) and Sjögren syndrome are chronic autoimmune inflammatory disorders that can present with multiorgan involvement including the lungs. This review will focus on recent literature pertaining to the epidemiology, pathogenesis, clinical presentation and diagnosis and management of SLE and Sjögren syndrome-associated pulmonary conditions.

RECENT FINDINGS

Pulmonary manifestations of both disease entities have been well characterized and lung involvement can be observed during the course of the disease in most cases. Pulmonary manifestations of SLE and Sjögren syndrome can be classified based on anatomical site of involvement; and the large and small airways, lung parenchyma, lung vasculature, pleura and respiratory muscles can be involved. The pleura is most commonly involved in SLE, whereas the airways are most commonly involved in primary Sjögren's syndrome (pSS). Sleep disturbances have also been described in both entities.

SUMMARY

Although further research into treatment strategies for the pulmonary complications seen in SLE and pSS is needed, the clinician should be aware of the risk factors and clinical presentation of the various pulmonary complications in SLE and pSS in order to identify patients who should be screened and/or have modifications in treatment strategies to mitigate the morbidity and mortality associated with these complications.

摘要

目的综述

系统性红斑狼疮(SLE)和干燥综合征是慢性自身免疫性炎症性疾病,可累及多器官,包括肺部。本篇综述将重点关注 SLE 和干燥综合征相关肺部疾病的最新文献,内容涉及流行病学、发病机制、临床表现、诊断和治疗。

最近的发现

这两种疾病的肺部表现均已有明确描述,在大多数情况下,疾病过程中均可观察到肺部受累。SLE 和干燥综合征的肺部表现可根据受累的解剖部位进行分类,包括大气道、小气道、肺实质、肺血管、胸膜和呼吸肌。SLE 最常累及胸膜,而原发性干燥综合征(pSS)最常累及气道。两种疾病还都伴有睡眠障碍。

总结

尽管需要进一步研究 SLE 和 pSS 肺部并发症的治疗策略,但临床医生应了解 SLE 和 pSS 中各种肺部并发症的危险因素和临床表现,以便识别应进行筛查的患者,或调整治疗策略以减轻这些并发症相关的发病率和死亡率。

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