系统性红斑狼疮合并间质性肺炎的临床特征及相关危险因素分析  

Clinical characteristics and correlative risk factors of interstitial pneumonia in systemic lupus erythematosus

作　　者：陈晓芳 杨敏[1] 赵进军[1] 赖伟男[1] 郝鹏[2] CHEN Xiaofang;YANG Min;ZHAO Jinjun;LAI Weinan;HAO Peng(Department of Rheumatology,the Affiliated Nanfang Hospital of Nanfang Medical University,Guangzhou,Guangdong 510515,China;Imaging Center,the Affiliated Nanfang Hospital of Nanfang Medical University,Guangzhou,Guangdong 510515,China)

机构地区：[1]南方医科大学南方医院风湿免疫科,广州510515 [2]南方医科大学南方医院影像中心,广州510515

出　　处：《重庆医学》2018年第11期1460-1464,共5页Chongqing medicine

基　　金：国家自然科学基金资助项目(81172875)

摘　　要：目的探讨系统性红斑狼疮合并间质性肺炎(SLE-IP)的临床特征并分析其相关危险因素。方法回顾性分析2013年1月至2016年1月于该院风湿免疫科住院且明确诊断的SLE-IP病例40例,并选择年龄、性别等相匹配的40例系统性红斑狼疮(SLE)未合并间质性肺炎的患者作为对照组。比较两组患者的临床表现、常规检查、生化检查和免疫学检查结果,分析SLE-IP发生的危险因素。结果该研究SLE-IP的高分辨CT分型以非特异性间质性肺炎(NSIP)多见,寻常型间质性肺炎(UIP)次之。NSIP以两肺磨玻璃样阴影多见,UIP以网格状影、蜂窝影多见。两组间干咳、胸闷/气短、雷诺现象、湿啰音、三酰甘油升高、Sm抗体阳性率、U1-nRNP抗体阳性率差异均有统计学意义(P<0.05)。Logistic回归分析显示干咳、胸闷/气短、雷诺现象、湿啰音、三酰甘油升高、Sm抗体阳性、U1-nRNP抗体阳性是发生SLE-IP的危险因素。结论干咳、胸闷/气短、雷诺现象、湿啰音、三酰甘油升高、Sm抗体阳性、U1-nRNP抗体阳性是发生SLE-IP的危险因素,及时完善HRCT检查有助于早期诊疗,改善患者预后。Objective To study the clinical characteristics and analyze the correlative risk factors of interstitial pneumonia in systemic lupus erythematosus(SLE-IP).Methods 80 SLE patients in department of rheumatology of Nanfang hospital form January 2013 to January 2016 were retrospectively analyzed.SLE patients with interstitial pneumonia(n=40)were divided into case group.40 cases of SLE with interstitial pneumonia were selected and matched with age and sex.Patients with mild SLE without interstitial pneumonia were treated as controls.The clinical manifestations,routine examination,biochemical examination and immunological examination were performed to compare the risk factors of SLE-related interstitial pneumonia.Results In this study,non-specific interstitial pneumonia(NSIP)and usual interstitial pneumonia(UIP)were common in SLE-IP patients.the ground-glass opacities were more common in NSIP type,while Grid shadows and honeycomb shadows were more common in UIP type.The dry cough,chest tightness/shortness of breath,Raynaud′s phenomenon,wet rales,triglyceride increased,anti-Sm antibody positive rate,anti-U1-nRNP positive rate between two groups were statistically significant(P<0.05).Logistic regression analysis showed that the risk factors of SLE-IP were dry cough,chest tightness/shortness of breath,Raynaud′s phenomenon,wet rales,triglyceride increased,anti-Sm antibody positive and anti-U1-nRNP positive.Conclusion The presence of dry cough,chest tightness/shortness of breath,Raynaud′s phenomenon,wet rales,triglyceride increased,anti-Sm antibody positive and anti-U1-nRNP positive all suggest the probability of interstitial pneumonia in SLE patients.HRCT plays an important role in the diagnosis of interstitial pneumonia in lupus,which is valuable to improve the prognosis.

关 键 词：红斑狼疮 系统性 间质性肺炎 危险因素 

分 类 号：R593.241[医药卫生—内科学]