Wohlgelernter D, Loke J, Matthay R A, Siegel N J
Yale J Biol Med. 1978 Mar-Apr;51(2):157-64.
To determine the prevalence of pulmonary dysfunction in lupus erythematosus, 24 patients with systemic lupus erythematosus (SLE) and 5 patients with discoid lupus erythematosus (DLE) were studied. Diffusing capacity for carbon monoxide was abnormal in 17 (71 percent) SLE patients. A restrictive ventilatory defect was present in 6 (25 percent) and arterial hypoxemia in 4 of 23 (17 percent). The mean ratio of forced expiratory volume in one second to forced vital capacity (FVC) was 83 percent. To test for the presence of small airways disease, maximum expiratory flow rate at 50 percent of FVC was measured on air and on an 80 percent helium-20 percent oxygen mixture. Ten patients (5 smokers and 5 nonsmokers) with SLE were nonresponders to helium suggesting small airways disease. Pulmonary dysfunction was present in 90 percent (9/10) of SLE patients with a previous history of pleuritis and/or pneumonitis, and in 71 percent (10/14) without respiratory symptoms or history of lung disease and with a normal chest radiograph. Pulmonary function tests were normal in DLE patients except for an abnormal response to helium and/or mild arterial hypoxemia in two patients, all of whom were smokers. These data indicate that there is a high prevalence of pulmonary function abnormalities in SLE including patients without clinically evident pleuropulmonary disease.
为了确定红斑狼疮患者肺功能障碍的患病率,对24例系统性红斑狼疮(SLE)患者和5例盘状红斑狼疮(DLE)患者进行了研究。17例(71%)SLE患者一氧化碳弥散能力异常。6例(25%)存在限制性通气功能障碍,23例中有4例(17%)存在动脉血氧不足。一秒用力呼气容积与用力肺活量(FVC)的平均比值为83%。为检测小气道疾病的存在,在空气和80%氦 - 20%氧混合气条件下测量了FVC 50%时的最大呼气流量。10例SLE患者(5例吸烟者和5例非吸烟者)对氦无反应,提示存在小气道疾病。有胸膜炎和/或肺炎病史的SLE患者中90%(9/10)存在肺功能障碍,无呼吸道症状、无肺部疾病史且胸部X线片正常的患者中71%(10/14)存在肺功能障碍。除2例对氦反应异常和/或有轻度动脉血氧不足外,DLE患者肺功能检查均正常,这2例均为吸烟者。这些数据表明,SLE患者肺功能异常的患病率很高,包括无临床明显胸膜肺部疾病的患者。