Xia F F, Lu F A, Lv H M, Yang G A, Liu Y
Department of Rheumatology, First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014010, Inner Mongolia, China.
Central Laboratory, First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou 014010, Inner Mongolia, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2021 Mar 4;53(2):266-272. doi: 10.19723/j.issn.1671-167X.2021.02.006.
To investigate the clinical features, radiologic scores and clinically relevant risk factors prognosis of secondary interstitial lung disease (ILD) in patients with systemic lupus erythematosus (SLE).
In this study, 60 SLE patients in Department of Rheumatology of the First Affiliated Hospital of Baotou Medical College and Taizhou First People's Hospital from January 2015 to March 2019 were retrospectively analyzed. All of those 60 patients with SLE underwent lung high resolution computed tomography (HRCT) examination. We used a 1 ∶1 case-control study. There was a matching of age and gender between the two groups. Thirty patients with SLE related ILD (SLE-ILD) were in the case group, and 30 patients with SLE without ILE (SLE non-ILD) were in the control group. The clinical features, pulmonary function test, radiologic characteristic of SLE patients were collected and were used to analyze SLE-ILD.
In this study, we reached the following conclusions: First, there were statistically significant differences in chest tightness/shortness of breath, Raynaud's phenomenon, and Velcro rale between SLE-ILD and SLE non-ILD patients (both < 0.05); Second, hemoglobin (Hb) and albumin (ALB) in the patients of SLE-ILD had a significant decrease compared with the patients of SLE non-ILD. Blood urea nitrogen (BUN), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) increased in SLE-ILD patients compared with SLE non-ILD patients, the difference had statistical significance ( < 0.05); Third, for SLE-ILD patients, the most common type was non-specific interstitial pneumonia (NSIP), followed by usual interstitial pneumonia and lymphocytic interstitial pneumonia; Fourth, there was no significant difference in clinical-radiology-physiology scores between the different ILD types (P>0.05), similarly, the lung HRCT score and lung function between different ILD types had no significant difference (P>0.05); Fifth, multivariate Logistic regression analysis showed that decreased albumin and chest tightness/shortness of breath might be the risk factor for SLE-ILD.
There are statistically significant differences between the SLE-ILD group and SLE non-ILD group in terms of chest tightness/shortness of breath, Velcro rale and Raynaud's phenomenon. Decreased albumin and chest tightness/shortness of breath in SLE patients should be alerted to the occurrence of ILD. NSIP is the most common manifestation of SLE-ILD.
探讨系统性红斑狼疮（SLE）患者继发性间质性肺疾病（ILD）的临床特征、放射学评分及临床相关危险因素与预后的关系。
本研究回顾性分析了包头医学院第一附属医院和泰州市人民医院风湿科2015年1月至2019年3月期间的60例SLE患者。这60例SLE患者均接受了肺部高分辨率计算机断层扫描（HRCT）检查。采用1∶1病例对照研究，两组在年龄和性别上进行匹配。病例组为30例SLE相关ILD（SLE-ILD）患者，对照组为30例无ILD的SLE（SLE非ILD）患者。收集SLE患者的临床特征、肺功能检查、放射学特征，并用于分析SLE-ILD。
在本研究中，我们得出以下结论：第一，SLE-ILD患者与SLE非ILD患者在胸闷/气短、雷诺现象和捻发音方面存在统计学显著差异（均P<0.05）；第二，SLE-ILD患者的血红蛋白（Hb）和白蛋白（ALB）较SLE非ILD患者显著降低。SLE-ILD患者的血尿素氮（BUN）、红细胞沉降率（ESR）和C反应蛋白（CRP）较SLE非ILD患者升高，差异具有统计学意义（P<0.05）；第三，对于SLE-ILD患者，最常见的类型是非特异性间质性肺炎（NSIP），其次是寻常型间质性肺炎和淋巴细胞间质性肺炎；第四，不同ILD类型之间的临床-放射学-生理学评分无显著差异（P>0.05），同样，不同ILD类型之间的肺HRCT评分和肺功能也无显著差异（P>0.05）；第五，多因素Logistic回归分析显示，白蛋白降低和胸闷/气短可能是SLE-ILD的危险因素。
SLE-ILD组与SLE非ILD组在胸闷/气短、捻发音和雷诺现象方面存在统计学显著差异。SLE患者白蛋白降低和胸闷/气短应警惕ILD的发生。NSIP是SLE-ILD最常见的表现。
