系统性硬化症患者静息肺功能的变化

目的:比较分析系统性硬化症(SSc)患者有、无呼吸道症状等不同状态时静息肺功能的变化,以观察其不同阶段肺损害的程度.方法:选择临床确诊的SSc患者68例,男10例,女58例,平均年龄41.5岁,测定静息肺功能的变化.结果:无任何呼吸道症状组胸片异常占23.2%,弥散功能障碍高达91.1%,限制型通气功能障碍占42.3%,小气道功能障碍占56.8%.有呼吸道症状组胸片异常占66.7%.无呼吸道症状组和胸片正常组SSc患者实测值占预计值%均有2项均值(FEF_(25%～75%)和DLco)异常,而有呼吸道症状组和胸片异常组则分别有5项异常.四组均以DLco、FEF_(25%～75%)和PEF下降的发生率和下降幅度最大.各组FEV_1/EVC均在正常范围内.胸片正常组VC、TLC、FRC和DLco明显高于异常组.结论:SSc肺功能改变与呼吸系统症状和胸片异常改变有关,且早于呼吸系统症状出现和胸片异常改变前.弥散功能障碍和小气道病变是SSc早期肺功能改变.肢端型SSc亦有很高比例的肺功能损害.SSc早期存在代偿性肺气肿.

Observation of Static Lung Function in Systemic Sclerosis

To observe the impairment severity of lung function in different stage of 68 cases (male 10, female 58, mean age 41. 5 years old) with systemic sclerosis (SSc). The results showed that in free respiratory symptom group, the percentage of abnormal chest film was 23. 2% (10/43), diffusing capacity dysfunction 91. 1%, restrictive ventilation dysfunction 42. 3%, and small airway dysfunction 56. 8%. 2 indexes of % pre lung function were abnormal both in free respiratory symptom group and normal chest film group. DLco, FEF25%-75% and PEF decreased significantly in all patients. VC,TLC,FRC and DLco was higher in normal chest film group than that in abnormal group, respectively. Conclusion: The impairment of lung function in SSc was closely related to respiratory symptoms and X-ray film. Dysfunction of diffusing capacity and smallairway was the earliest change of lung function in SSc.