Grohs M, Moazedi-Fuerst F C, Flick H, Hackner K, Haidmayer A, Handzhiev S, Kiener H, Löffler-Ragg J, Mathis G, Mostbeck G, Schindler O, Widmann G, Prosch H
BVAEB - Rehabilitationszentrum Engelsbad, Weilburgstr. 7-9, 2500, Baden, Österreich.
Klinische Abteilung für Rheumatologie und Immunologie, Medizinische Universität Graz, Auenbruggerplatz 15, 8036, Graz, Österreich.
Z Rheumatol. 2022 Sep;81(7):610-618. doi: 10.1007/s00393-022-01206-4. Epub 2022 May 5.
Lung involvement is the most frequent cause of death in patients with systemic sclerosis (SSc). As lung involvement is frequently asymptomatic, the current recommendation is to carry out thoracic computed tomography (CT) in all patients newly diagnosed with SSc. There is currently disagreement on how patients with SSc for whom no lung involvement was found at the time of diagnosis, should be followed up. Based on a consensus of Austrian rheumatologists, pneumologists and radiologists it is recommended that for asymptomatic patients with a negative CT at the time of initial diagnosis, a transthoracic ultrasound examination should be carried out annually and a lung function examination every 6-12 months. In the presence of a positive lung ultrasound finding a supplementary CT for further clarification is recommended. Based on the data situation, annual CT follow-up controls are recommended for patients with a high risk as defined by appropriate risk factors.
肺部受累是系统性硬化症(SSc)患者最常见的死亡原因。由于肺部受累通常没有症状,目前的建议是对所有新诊断为SSc的患者进行胸部计算机断层扫描(CT)。目前对于在诊断时未发现肺部受累的SSc患者应如何进行随访存在分歧。基于奥地利风湿病学家、肺病学家和放射学家的共识,建议对于初诊时CT阴性的无症状患者,每年进行一次经胸超声检查,每6 - 12个月进行一次肺功能检查。如果肺部超声检查结果为阳性,建议进行补充CT检查以进一步明确。根据现有数据情况,对于由适当风险因素定义的高危患者,建议每年进行CT随访检查。