狼疮性肾炎患者肺功能损害特征及其相关因素分析

目的　探讨狼疮性肾炎患者肺功能损害的特征及其相关因素。方法　测定 40例狼疮性肾炎患者的肺容量、通气功能、小气道功能、弥散功能和血红蛋白、BUN及血压。结果　肺活量 (VC)、残气容积与肺总量之比值 (RV/TLC)、第一秒肺活量 (FEV1)、最大通气量 (MVV)、一氧化碳弥散量 (DLCO)、每升肺泡通气量之CO弥散量 (DLCO/VA)与对照组比较 ,差异有显著性 (P <0 .0 5 ) ,其中 30 %的患者呈现肺气肿现象 ,30 %的患者肺通气功能减低 ,小气道阻塞和可疑小气道阻塞者高达 6 0 % ,更有高达 85 %的患者弥散功能减退 ;相关因素分析表明 ,DLCO与TLC明显正相关关系 (r =0 .42 ,P <0 .0 5 )。结论　狼疮性肾炎患者肺功能损害以弥散功能减退为主 ,限制性通气障碍与阻塞性通气障碍并存 ,且以限制性通气障碍为主要发展趋势 ,与其他结缔组织疾病一样弥散功能障碍先于肺X线表现 ,但其呼吸困难症状几乎与弥散功能同步出现 ,则与其他结缔组织疾病有所不同

The features of pulmonary function disturbance and the correlation factors in lupus nephritis

Objective To describe the features of pulmonary function disturbance and the correlation factors in systemic lupus erythematosus complicated with lupus nephritis.Methods Lung capacity?ventilatory function?small airway function?diffusing capacity?hemoglobin(Hb)?BUN and blood pressure were measured in 40 patients with lupus nephritis.Results VC?RV/TLC?FEV 1?MVV?D LCO?D LCO /V A had significant difference compare with the controls(P<0.05). Emphysema changes were seen in 30% of the patients, 30% of the patients showed decrease of ventilatory function, the incidence of small airway obstruction and suspicious small airway obstruction was 60% and constituting 85% of the patients had abnormal diffusing capacity. This research indicated that there was a close relation between D LCO and TLC( r =0.42, P <0.05).Conclusion The most characteristic pulmonary function change in lupus nephritis was decrement of diffusing capacity. Restrictive ventilatory disorder is dominant and coexist with obstructive ventilatory disorder. It has no difference with other CTD that diffusing function was prior to the chest X ray, but it is quite different with other CTD that dyspnea and decrement of diffusing capacity were seen at the same time.