原发性干燥综合征合并间质性肺病患者临床与影像特点分析

目的 探讨原发性干燥综合征合并间质性肺病(pSS-ILD)患者临床与影像学特点。 方法 选取2012年1月—2017年12月在杭州师范大学附属医院就诊的148例原发性干燥综合征(pSS)患者进行回顾性分析，根据胸部HRCT是否伴有间质性改变分为ILD组(39例)，对照组(109例)，比较2组间临床表现、实验室指标及肺功能差异，分析ILD组影像学特点。 结果 ①ILD组患者平均年龄及发病年龄均大于对照组，差异有统计学意义(均P<0.05)。②ILD组干咳、气促、乏力及精神症状发生率显著高于对照组(均P<0.05)。③ILD组抗核抗体、抗SSA抗体及类风湿因子阳性率显著高于对照组(均P<0.05)。④ILD组患者DLCO占预计值百分比显著低于对照组(P<0.05)；ILD组平均肺动脉压及肺动脉高压比例均高于对照组(均P<0.05)。⑤pSS-ILD患者以磨玻璃影为最常见影像学表现，其次为网格影及牵拉性支气管扩张。 结论 pSS-ILD发病年龄较晚，临床症状更为多样；pSS-ILD患者血清抗核抗体、抗SSA抗体及类风湿因子阳性率较高；pSS-ILD患者更易出现肺动脉高压；pSS-ILD患者影像学表现以磨玻璃影最为常见。 

Analysis of clinical and imaging features of primary Sjogren's syndrome complicated with interstitial lung disease

Objective To investigate the clinical and imaging features of patients with primary Sjogren's syndrome (pSS) complicated with interstitial lung disease (ILD). Methods The clinical and imaging data of 148 cases of pSS were reviewed in last 6 years. Thirty nine patients with -ILD were assigned into ILD group, and 109 patients with pSS without ILD into the control group. The clinical manifestations, immunological parameters and lung function were compared between the two groups. The imaging findings in ILD group were studied. Results ①The mean age and age of onset in the ILD group were significantly higher than those in the control group (P<0.05). ②The incidence of dry cough, shortness of breath, fatigue and psychiatric symptoms in ILD group was significantly higher than that the control group (all P<0.05). ③The positive rates of ANA, anti-SSA antibody and rheumatoid factor in ILD group were higher than those in the control group, the difference was statistically significant (all P<0.05). ④DLCO% of the predicted value in the ILD group was significantly lower than that in the control group (P<0.05). The mean pulmonary artery pressure and the proportion of pulmonary hypertension in the ILD group were higher than those in the control group (all P<0.05). ⑤Ground-glass opacity was the most common manifestation in ILD group, followed by mesh shadow and traction bronchiectasis. Conclusion ILD was a common manifestation of pSS with various clinical manifestations. The serum antinuclear antibody, anti-SSA antibody and rheumatoid factor positive rate were higher in pSS-ILD patients. The incidence of pulmonary hypertension was higher in pSS-ILD patients. Ground-glass opacity was the most common manifestation in pSS-ILD patients.