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系统性红斑狼疮患儿的肺部受累情况

Pulmonary Involvement in Children With Systemic Lupus Erythematosus.

作者信息

Dai Ge, Li Linlin, Wang Ting, Jiang Wujun, Ma Jie, Yan Yongdong, Chen Zhengrong

机构信息

Children's Hospital of Soochow University, Suzhou, China.

Children's Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Front Pediatr. 2021 Feb 2;8:617137. doi: 10.3389/fped.2020.617137. eCollection 2020.

Abstract

Symptomatic pulmonary involvement in systemic lupus erythematosus (SLE) seems not uncommon in children. However, there are few data on the characteristics and laboratory parameters of SLE patients with pulmonary involvement. This was a hospital-based study involving 111 SLE patients from 1 January 2012 to 31 December 2016. The demographic, clinical, and laboratory data of the patients were prospectively collected. They were followed as outpatients until December 2019. Clinical characteristics and laboratory parameters of patients with and without pulmonary involvement were compared. Of the 111 patients with SLE, we identified 18 patients (16.2%) with pulmonary involvement. The most common HRCT findings were ground glass opacity, interlobular septal thickening, bilateral diffuse infiltrates, and pleurisy/pleural effusion (55.6, 50, 50, and 44.4%, respectively). SLE patients with pulmonary involvement tended to have a longer disease duration (14 [12-24.5] vs. 5 [2-9] months, < 0.01). We also observed a significant association between the presence of anti-Sm antibody, ANCA, Anti-RNP and the presence of pulmonary involvement of SLE (all < 0.001). Lung involvement was frequent in SLE patients from Southeast China. Patients with a longer duration of symptoms before SLE diagnosis tended to have pulmonary involvement. When children with SLE are found to have anti-RNP antibody and positive ANCA, it should be alert to the occurrence of pulmonary involvement.

摘要

系统性红斑狼疮(SLE)患儿出现有症状的肺部受累似乎并不少见。然而,关于肺部受累的SLE患者的特征和实验室参数的数据却很少。这是一项基于医院的研究,纳入了2012年1月1日至2016年12月31日期间的111例SLE患者。前瞻性收集了患者的人口统计学、临床和实验室数据。对他们进行门诊随访直至2019年12月。比较了有和无肺部受累患者的临床特征和实验室参数。在111例SLE患者中,我们确定了18例(16.2%)有肺部受累。HRCT最常见的表现为磨玻璃影、小叶间隔增厚、双侧弥漫性浸润和胸膜炎/胸腔积液(分别为55.6%、50%、50%和44.4%)。有肺部受累的SLE患者往往病程更长(14[12 - 24.5]个月 vs. 5[2 - 9]个月,<0.01)。我们还观察到抗Sm抗体、ANCA、抗RNP的存在与SLE肺部受累之间存在显著关联(均<0.001)。中国东南部的SLE患者肺部受累很常见。SLE诊断前症状持续时间较长的患者往往有肺部受累。当SLE患儿被发现有抗RNP抗体且ANCA阳性时,应警惕肺部受累的发生。

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