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系统性硬化症合并间质性肺病的临床特征

Clinical Characteristics of Systemic Sclerosis With Interstitial Lung Disease.

作者信息

Jung Eunju, Suh Chang-Hee, Kim Hyoun-Ah, Jung Ju-Yang

机构信息

Department of Rheumatology, Ajou University College of Medicine, Suwon, South Korea.

出版信息

Arch Rheumatol. 2018 Jan 15;33(3):322-327. doi: 10.5606/ArchRheumatol.2018.6630. eCollection 2018 Sep.

Abstract

OBJECTIVES

This study aims to compare the clinical characteristics of systemic sclerosis (SSc) patients with or without interstitial lung disease (ILD), and figure out whether the differences can be useful to suspect ILD in SSc.

PATIENTS AND METHODS

We retrospectively collected the clinical data of 108 patients with SSc (13 males, 95 females; mean age 50.1±13.5 years; range 14 to 78 years) and compared them according to the presence of ILD. ILD was confirmed by chest computed tomography, and pulmonary arterial hypertension was suspected when right ventricular systolic pressure was ≥40 mmHg based on echocardiography.

RESULTS

Of the 108 patients, 49 (45.4) had diffuse type and 59 (54.6) had limited type SSc. Disease duration, percentages of positive anti-scleroderma 70 (anti-Scl70) antibody and anti-centromere antibody, white blood cell, platelet, erythrocyte sedimentation rate (ESR), and presence of pulmonary hypertension differed significantly. On multivariate logistic analysis, positive titer of anti-Scl70 antibody (odds ratio [OR]=15.65, p<0.001), platelet (OR=1.01, p=0.026), ESR (OR=1.02, p=0.037) and pulmonary hypertension (OR=21.97, p=0.003) were associated with ILD in patients with SSc.

CONCLUSION

In SSc patients with ILD, disease duration was longer and positive titer of anti-Scl70 antibody was more frequent, positive titer of anti- centromere antibody was less frequent, and white blood cell and platelet counts, ESR levels, and incidence of possible pulmonary hypertension were significantly higher than in those without ILD. Positive titer of anti-Scl70 antibody, platelet, ESR, and combination of pulmonary hypertension were independently associated with the presence of ILD in SSc patients.

摘要

目的

本研究旨在比较合并或不合并间质性肺疾病(ILD)的系统性硬化症(SSc)患者的临床特征,并确定这些差异是否有助于怀疑SSc患者存在ILD。

患者与方法

我们回顾性收集了108例SSc患者(男性13例,女性95例;平均年龄50.1±13.5岁;年龄范围14至78岁)的临床资料,并根据是否存在ILD进行比较。ILD通过胸部计算机断层扫描确诊,当基于超声心动图右心室收缩压≥40 mmHg时怀疑存在肺动脉高压。

结果

108例患者中,49例(45.4%)为弥漫型SSc,59例(54.6%)为局限型SSc。病程、抗硬皮病70(抗Scl70)抗体和抗着丝点抗体阳性率、白细胞、血小板、红细胞沉降率(ESR)以及肺动脉高压的存在情况存在显著差异。多因素逻辑回归分析显示,抗Scl70抗体阳性滴度(比值比[OR]=15.65,p<0.001)、血小板(OR=1.01,p=0.026)、ESR(OR=1.02,p=0.037)和肺动脉高压(OR=21.97,p=0.003)与SSc患者的ILD相关。

结论

在合并ILD的SSc患者中,病程更长,抗Scl70抗体阳性滴度更常见,抗着丝点抗体阳性滴度更少见,白细胞和血小板计数、ESR水平以及可能的肺动脉高压发生率显著高于未合并ILD的患者。抗Scl70抗体阳性滴度、血小板、ESR以及肺动脉高压的联合情况与SSc患者ILD的存在独立相关。

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