原发性干燥综合征合并间质性肺病38例临床分析

目的分析呼吸内科收治的原发性干燥综合症（SS）相关间质性肺病（ILD）的临床特点。方法对2003年1月-2011年7月之间北京大学人民医院呼吸内科收治的SS相关ILD患者资料统计分析。结果共统计患者38例,27例（71.1%）因ILD首诊。32例行肺功能检查,25例（78.1%）弥散功能降低;14例（43.7%）为限制性通气障碍。所有患者胸部高分辨CT（HRCT）均显示ILD,其中7例肺功能正常。23例长期口服糖皮质激素,12例复查胸部HRCT,共9例ILD吸收好转,其中6例支气管肺泡灌洗液（BALF）淋巴细胞增高者经糖皮质激素治疗肺部病变均好转,3例胸部HRCT无明显蜂窝形成但无BALF结果者经糖皮质激素治疗有2例吸收好转。结论 SS常以ILD为首诊原因。胸部HRCT对ILD诊断价值优于肺功能。BALF淋巴细胞升高和/或胸部HRCT无明显蜂窝形成者经糖皮质激素治疗肺部病变可吸收好转。

Clinical characteristics of Sjogren syndrome associated interstitial lung disease

Objective To analyze the clinical characteristics of patients with （Sjogren syndrome, SS） associated interstitial lung disease OLD）. Methods In-patients with SS associated ILD in respiratory department of people＇ s hospital of Peking university during 1,1,2003-7,31,2011 were retrospectively analyzed.Results 38 patients with SS associated ILD were analyzed, and ILD was the initial manifestation of SS in 27 cases（71.1%）. 32 cases took lung function test and 21 of them represented as decrease of diffusing capacity, 14 as restrictive hypoventilation. 38 patients took chest high resolution CT scan （HRCT） test and all had ILD in HRCT （7 of them had normal lung function）. 23 patients were treated with long-period corticosteroid, 12 cases of them took HRCT scan after treatment. The opacity in CT scan was absorbed in 6 cases in that lymphocyte percentage of bronchoalveolar lavage fluid （BALF） increased. The opacity in CT scan was absorbed in 2 of 3 cases with little honeycombing in chest HRCT but didn＇t have BALF test. Conclusion These results suggest that： SS is common cause of ILD and ILD often be the initial manifestation of SS. HRCT is more sensitive for diagnosis of ILD compared with lung function. The opacity in CT scan can be absorbed after treatment of corticosteroid in patients with lymphocyte percentage of BALF increased an/or little honeycombing in chest HRCT.