Department of Rheumatology, Beijing Chao-yang Hospital, Capital Medical University, Chaoyang District, Beijing, China.
Department of Radiology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2023 Feb 22;102(8):e32952. doi: 10.1097/MD.0000000000032952.
To investigate the characteristics of elderly-onset primary Sjögren syndrome (pSS) using chest high-resolution computed tomography and pulmonary function tests (PFTs). The data of 102 patients with pSS with interstitial lung disease were retrospectively analyzed. The chest high-resolution computed tomography, PFTs, and clinical and laboratory data were evaluated based on the age of onset: elderly-onset pSS (EopSS) (≥65 years) versus adult-onset pSS (AopSS) (<65 years). Among the 102 patients with pSS-interstitial lung disease, there were 34 of EopSS and 68 of AopSS. EopSS patients presented a significantly higher incidence of usual interstitial pneumonia (EopSS [38.2%] vs AopSS [11.8%], P = .005) and a significantly lower incidence of nonspecific interstitial pneumonia (EopSS [8.8%] vs AopSS [25%], P = .042). Unlike the AopSS group, the significant decreases in the vital capacity (VC) (the percentage of the predicted value of each parameter [%pred]) and the forced VC (%pred), PFTs showed that VC (%pred) and forced VC (%pred) were >80% in the EopSS group. Forced expiratory volume in 1 second significantly decreased and residual volume significantly increased in the EopSS group (P = .001). The percentage of small airway disease was significantly higher in the EopSS group (P = .021). Diffusing capacity of the lung for carbon monoxide/alveolar volume (%pred) was <80% in both groups with a lower percentage in the AopSS group. Usual interstitial pneumonia is more common in the EopSS group. Although there is no significant difference in ventilation dysfunction between the EopSS and AopSS groups, small airway disease is more common in the EopSS group, while restrictive ventilatory dysfunction is more common in the AopSS group. Therefore, the EopSS group has its own characteristics and it is worth studying and noting.
利用胸部高分辨率 CT 和肺功能检查（PFTs）探讨老年起病原发性干燥综合征（pSS）的特点。方法：回顾性分析 102 例 pSS 合并间质性肺病患者的临床资料，根据发病年龄分为老年起病 pSS（EopSS）组（≥65 岁）和成年起病 pSS（AopSS）组（<65 岁），比较两组患者胸部高分辨率 CT、PFTs 及临床和实验室资料。结果：102 例 pSS 合并间质性肺病患者中，EopSS 患者 34 例，AopSS 患者 68 例。EopSS 患者中常见间质性肺炎的发生率明显高于 AopSS 患者（EopSS[38.2%]比 AopSS[11.8%]，P=0.005），而非特异性间质性肺炎的发生率明显低于 AopSS 患者（EopSS[8.8%]比 AopSS[25%]，P=0.042）。与 AopSS 组不同，EopSS 组肺活量（VC）（各参数实测值占预计值的百分比[%pred]）和用力肺活量（FVC）（%pred）显著下降，FVC（%pred）和 FVC（%pred）>80%。EopSS 组第 1 秒用力呼气容积（FEV1）明显下降，残气量明显增加（P=0.001）。EopSS 组小气道疾病的发生率明显高于 AopSS 组（P=0.021）。两组一氧化碳弥散量/肺泡容积（%pred）均<80%，AopSS 组较低。常见间质性肺炎在 EopSS 组更常见。尽管 EopSS 和 AopSS 组之间通气功能障碍无显著差异，但 EopSS 组小气道疾病更常见，而 AopSS 组限制性通气功能障碍更常见。因此，EopSS 组有其自身特点，值得研究和注意。
