肺型原发性干燥综合征的胸部高分辨率 CT 特征和肺功能检查结果。

The characteristics of chest HRCT and pulmonary function tests in lung-onset primary sjogren's syndrome.

机构信息

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

Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

出版信息

Immun Inflamm Dis. 2023 Aug;11(8):e957. doi: 10.1002/iid3.957.

DOI:10.1002/iid3.957

PMID:37647425

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10408372/

Abstract

INTRODUCTION

Interstitial lung disease (ILD) can manifest before the diagnosis of primary Sjögren's syndrome (pSS), however, the underlying mechanisms remain unclear. The aim of this study is to investigate the characteristics of lung-onset pSS using chest high-resolution computerized tomography (HRCT) and pulmonary function tests (PFTs).

METHODS

The data of 102 patients with pSS-ILD were retrospectively analyzed. The patients were divided into two groups: lung-onset group and the nonlung-onset group. The chest HRCT, PFTs, and clinical and laboratory data were evaluated and compared.

RESULTS

Among the 102 patients with pSS-ILD, 59 (57.8%) were lung-onset and 43 (42.2%) were nonlung-onset. Chest HRCT in the lung-onset group showed higher percentage of usual interstitial pneumonia and nonspecific interstitial pneumonia, the difference did not reach statistical significance. The total HRCT score was higher in the lung-onset group, compared with the nonlung-onset group (2 [2, 3], vs. 2 [1, 2], p = .014). Total lung capacity (TLC) (%pred) [(75.4 ± 16.2) versus (82.8 ± 19.4), p = .049] and forced vital capacity (FVC) (%pred) [(82.2 ± 19.9) versus (91.6 ± 28.3), p = .050] were significantly lower in the lung-onset group, compared with the nonlung-onset group. Residual volume (RV)/TLC (%) significantly increased more than 40% in the lung-onset group (p = .015). Restricted ventilation disorder, small airway obstruction and reduced diffusing capacity of the lung for carbon monoxide/alveolar volume (%Pred) were more common in the lung-onset group (p = .038, p = .050, and p = .050, respectively). Correlation analysis showed that HRCT score was positively correlated with the interval between the onset of pulmonary symptoms and the diagnosis of ILD, serum CA125, and serum CEA. TCL (%pred), VC (%pred), FVC (%pred) were negatively correlated with serum CA125.

CONCLUSION

Lung-onset is common in pSS patients with more severe lung function impairments. Serum biomarkers, such CA125, CEA, and ALB, were associated with the severity of lung damage.

摘要

简介

间质性肺病（ILD）可在原发性干燥综合征（pSS）之前出现，但潜在机制尚不清楚。本研究旨在通过胸部高分辨率计算机断层扫描（HRCT）和肺功能检查（PFT）探讨肺首发 pSS 的特征。

方法

回顾性分析 102 例 pSS-ILD 患者的临床资料，根据是否合并肺外表现分为肺首发组（59 例）和非肺首发组（43 例）。比较两组患者的胸部 HRCT、PFT 及临床和实验室资料。

结果

102 例 pSS-ILD 患者中，59 例（57.8%）为肺首发，43 例（42.2%）为非肺首发。肺首发组胸部 HRCT 常见间质性肺炎和非特异性间质性肺炎比例较高，但差异无统计学意义。肺首发组总 HRCT 评分高于非肺首发组（2[2，3]分比 2[1，2]分，P=0.014）。与非肺首发组相比，肺首发组的总肺容量（TLC）%预计值[（75.4±16.2）%比（82.8±19.4）%，P=0.049]和用力肺活量（FVC）%预计值[（82.2±19.9）%比（91.6±28.3）%，P=0.050]均显著降低。肺首发组残气量（RV）/TLC（%）显著增加超过 40%（P=0.015）。限制性通气障碍、小气道阻塞和一氧化碳弥散量/肺泡容积（%预计值）降低在肺首发组更为常见（P=0.038、P=0.050 和 P=0.050）。相关性分析显示，HRCT 评分与肺症状出现至 ILD 诊断的时间间隔、血清 CA125 和 CEA 呈正相关，与 TLC %预计值、VC %预计值、FVC %预计值呈负相关。