系统性硬化症相关肺间质病变临床特征分析及随访观察

发布时间：2019-06-27 15:15

【摘要】：目的分析硬皮病(systemic sclerosis,SSc)相关肺间质病变(interstitial lung disease,ILD)的临床特征及治疗转归,为早期诊断SSc-ILD、改善疾病预后提供科学依据。方法选择SSc患者45例,收集临床资料,伴有肺间质病变的SSc-ILD患者35例治疗随访6个月,使用环磷酰胺患者18例(观察组)未使用环磷酰胺患者17例(对照组),评估治疗前后肺部高分辨率CT及肺功能。结果 SSc-ILD患者占SSc患者的77.8%。SSc-ILD患者关节炎、肌痛、胸闷气促的比例均高于SSc-非ILD组,差异有统计学意义(均有P0.05);SSc-ILD组血沉高于SSc-非ILD组(t=2.93,P=0.003);免疫球蛋白G低于SSc-非ILD组(t=-2.02,P=0.044)。SSc-ILD组用力肺活量(forced vital capacity,FVC)(t=-3.36,P=0.001)、一秒用力呼气容积(forced expiratory volume in one second,FEV1)(t=-3.01,P=0.003)、最大呼气流速(t=-1.07,P=0.008)、肺活量(vital capacity,VC)(t=-2.96,P=0.003)、功能残气量(t=-3.74,P0.001)、残气量(t=-3.25,P=0.001)、肺总量(t=-3.62,P=0.001)、一氧化碳弥散量(carbon monoxide diffusing capacity,DLCO)(t=-4.01,P0.001)均低于SSc组,差异有统计学意义。治疗后观察组较对照组肺功能指标FVC、FEV1/FVC、VC、DLCO明显改善,差异有统计学意义(均有P0.05)。结论肺功能检测对SSc-ILD诊断及分期具有一定临床价值,环磷酰胺治疗SSc-ILD有一定疗效。
[Abstract]:Objective to analyze the clinical features and treatment outcome of scleroderma (systemic sclerosis,SSc)-related pulmonary stroma disease (interstitial lung disease,ILD), and to provide scientific basis for early diagnosis of SSc-ILD, to improve the prognosis of the disease. Methods 45 patients with SSc were selected. 35 patients with SSc-ILD with pulmonary stroma lesions were followed up for 6 months. 18 patients with cyclophosphamide were treated with cyclophosphamide (observation group) and 17 patients without cyclophosphamide (control group). The lung high resolution CT and pulmonary function were evaluated before and after treatment. Results the proportion of arthritis, myalgia and shortness of breath in 77.8%.SSc-ILD patients with SSc-ILD was significantly higher than that in SSc- non-ILD group (P 0.05), erythrocyte sedimentation rate (erythrocyte sedimentation rate) in SSc-ILD group was higher than that in SSc- non-ILD group (t 鈮，

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