Peters-Golden M, Wise R A, Hochberg M C, Stevens M B, Wigley F M
Am J Med. 1984 Dec;77(6):1027-34. doi: 10.1016/0002-9343(84)90183-9.
In order to determine the predictive value of lung function studies for subsequent prognosis in systemic sclerosis, 71 patients with systemic sclerosis were followed up for a mean of five years after pulmonary function testing. A carbon monoxide diffusing capacity less than or equal to 40 percent of the predicted reference value was associated with only a 9 percent five-year cumulative survival rate compared with a 75 percent cumulative five-year survival in patients with a carbon monoxide diffusing capacity greater than 40 percent of predicted. An obstructive ventilatory defect was also associated with increased mortality, and all six patients with obstruction and a diffusing capacity less than 70 percent of the predicted died during the study period. Male gender, independent of abnormalities of pulmonary function, was also associated with a poor prognosis. Although it is not clear whether a severely impaired diffusing capacity is indicative of interstitial pulmonary fibrosis or pulmonary vasculopathy or is a marker of generalized vascular disease, a severely depressed carbon monoxide diffusing capacity is an important predictor of mortality in patients with systemic sclerosis.
为了确定肺功能研究对系统性硬化症后续预后的预测价值，对71例系统性硬化症患者在进行肺功能测试后平均随访了5年。一氧化碳弥散能力小于或等于预测参考值的40%时，5年累积生存率仅为9%，而一氧化碳弥散能力大于预测值40%的患者5年累积生存率为75%。阻塞性通气缺陷也与死亡率增加相关，在研究期间，所有6例有阻塞且弥散能力小于预测值70%的患者均死亡。男性，与肺功能异常无关，也与预后不良相关。虽然尚不清楚严重受损的弥散能力是间质性肺纤维化或肺血管病的指标，还是全身性血管疾病的标志，但一氧化碳弥散能力严重降低是系统性硬化症患者死亡率的重要预测指标。
