原发性干燥综合征相关肺囊性病变的影像学特点及危险因素探讨  

Cystic lung disease in primary Sj?gren’s syndrome:imaging characteristics and associated risk factors

作　　者：李德福 祝婷婷 庞颖 LI De-fu;ZHU Ting-ting;PANG Ying(Department of Radiology,Fuyong People's Hospital,Shenzhen 518103,China;Department of Radiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology)

机构地区：[1]广东省深圳市宝安区福永人民医院放射科,518103 [2]华中科技大学同济医学院附属同济医院放射科

出　　处：《天津医药》2021年第2期185-190,共6页Tianjin Medical Journal

摘　　要：目的探讨原发性干燥综合征(pSS)相关肺囊性病变(CLD)的影像学特点及危险因素,为治疗及预后提供参考。方法回顾性分析我院181例pSS患者的临床和影像资料,根据胸部CT有无肺囊性病变分为囊性变组(51例)和无囊性变组(130例),分析p SS相关肺囊性病变的胸部CT特点,比较2组间的临床症状和体征、实验室检查的差异,将临床重要变量和单因素Logistic分析P≤0.1的变量纳入多因素Logistic回归分析,研究pSS相关肺囊性病变的危险因素。结果与无囊性变组比较,有囊性变组病程较长,呼吸困难、口干症状比例较高(P<0.05);类风湿因子(RF)、IgG、IgA、IgM水平,抗SSB抗体、抗Ro52抗体阳性比例较高(P<0.05)。肺囊性病变以圆形为主,随机分布,大小不一,部分可见分隔、血管穿行或包绕,可合并磨玻璃影、结节及支气管壁增厚等改变,随访罕见增大。多因素Logistic回归分析显示,抗SSB抗体阳性是p SS相关CLD的独立危险因素(P<0.05)。结论pSS相关CLD以随机分布、囊内见分隔、血管穿行或包绕等特点为主。抗SSB抗体阳性的pSS患者发生肺囊性病变的风险较高。Objective To explore the imaging characteristics and associated risk factors of cystic lung disease(CLD)in primary Sj(o|")gren’s syndrome(pSS)and to provide reference for its treatment and prognosis.Methods The clinical and imagine data of 181 patients with pSS in our hospital were retrospectively analyzed.According to the presence or absence of pulmonary cystic lesions on chest CT,the patients were divided into two groups:the group with cystic lesions(51 cases)and the group without cystic lesions(130 cases).The characteristics of chest CT of CLD related to pSS were analyzed.The differences of clinical symptoms,physical signs and laboratory examinations were compared between the two groups by casecontrol univariate analysis.The important clinical variables and univariate P value≤0.1 variables were included in the multivariate Logistic regression analysis of possible risk factors.Results Compared with the non-cystic lesion group,there were longer course of disease and a higher proportion of dyspnea and dry mouth symptoms in cystic lesion group(P<0.05).IgG,IgA,IgM,RF values,anti-SSB antibody,anti-Ro52 antibody positive ratio were higher in cystic lesion group than those of the non-cystic lesion group(P<0.05).The pulmonary cystic lesions were mainly round,randomly distributed and of different sizes,with septum,blood vessels passing through or wrapping around,which could be combined with ground glass opacity,nodular and bronchial wall thickening,rarely increased in follow-up.Multiple Logistic regression analysis revealed that the positive anti SSB antibody was an independent risk factor of pSS related CLD(P<0.05).Conclusion The main characteristics of pSS related CLD are random distribution,intrathecal separation,vascular penetration or vascular wrapping.Patients with pSS positive for anti-SSB antibodies have a higher risk of developing CLD.

关 键 词：干燥综合征 体层摄影术 螺旋计算机 放射摄影术 胸部 肺囊性病变 抗SSB抗体 

分 类 号：R445.3[医药卫生—影像医学与核医学] R593.2[医药卫生—诊断学]