原发性干燥综合征相关间质性肺病在中国人群中的进展和预后的危险因素。

Risk factors for progression and prognosis of primary Sjögren's syndrome-associated interstitial lung disease in a Chinese population.

机构信息

Department of Rheumatology and Immunology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

Department of Rheumatology and immunology, Henan Province People's Hospital, Zhengzhou City, China.

出版信息

Int J Rheum Dis. 2020 Dec;23(12):1734-1740. doi: 10.1111/1756-185X.14023. Epub 2020 Nov 23.

Abstract

OBJECTIVE

This study explored differences between primary Sjögren's syndrome-associated interstitial lung disease (pSS-ILD) patients with and without ILD progression, and analyzed the factors affecting the progression and prognosis of pSS-ILD.

METHODS

This study is a retrospective cohort study which enrolled 113 pSS-ILD patients hospitalized between 2011 and 2017.

RESULTS

The 3-year survival rate of the pSS-ILD patients was 91.15%, and the 5-year survival rate was 84.07%. Univariate analysis showed that Raynaud's syndrome, hypoproteinemia, extensive lung involvement, possible usual interstitial pneumonia pattern were risk factors for the progression of ILD in patients with pSS-ILD, and cyclophosphamide was a protective factor for the progression of ILD in patients with pSS-ILD. Multiple logistic regression analysis showed that extensive lung involvement (odds ratio 4.143, 95% CI: 1.203-14.267, P < .05) was an independent risk factor for the progression of pSS-ILD. Cox hazard analysis showed that pSS-ILD with hypoproteinemia (hazard ratio [HR] 17.758, 95% CI: 4.753-66.340, P <- .05) and extensive lung involvement (HR 3.450, 95% CI: 1.419-8.390, P < .05) were associated with worse survival of patients.

CONCLUSION

Extensive lung involvement is an independent risk factor for the progression of ILD in patients with pSS-ILD. Hypoproteinemia and extensive lung involvement are independent risk factors for mortality in patients with pSS-ILD, after controlling for potentially influential variables.

摘要

目的

本研究旨在探讨原发性干燥综合征相关性间质性肺病(pSS-ILD)患者中ILD 进展与未进展患者之间的差异,并分析影响 pSS-ILD 进展和预后的因素。

方法

本研究为回顾性队列研究,共纳入 2011 年至 2017 年期间住院的 113 例 pSS-ILD 患者。

结果

pSS-ILD 患者的 3 年生存率为 91.15%,5 年生存率为 84.07%。单因素分析显示,雷诺现象、低蛋白血症、广泛肺受累、可能的寻常型间质性肺炎模式是 pSS-ILD 患者 ILD 进展的危险因素,环磷酰胺是 pSS-ILD 患者 ILD 进展的保护因素。多因素 logistic 回归分析显示,广泛肺受累(比值比 4.143,95%置信区间:1.203-14.267,P<.05)是 pSS-ILD 进展的独立危险因素。Cox 风险分析显示,低蛋白血症(风险比 [HR] 17.758,95%置信区间:4.753-66.340,P<.05)和广泛肺受累(HR 3.450,95%置信区间:1.419-8.390,P<.05)与 pSS-ILD 患者的生存状况较差相关。

结论

广泛的肺受累是 pSS-ILD 患者 ILD 进展的独立危险因素。在控制潜在影响因素后,低蛋白血症和广泛的肺受累是 pSS-ILD 患者死亡的独立危险因素。

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