CAJ | 학술논문

目的：探讨合并间质性肺病( ILD)的原发性干燥综合征( pSS)患者肺动脉压力变化及其与肺功能、预后的关系。方法分析南京市鼓楼医院及南京鼓楼医院集团宿迁市人民医院2009年1月至2013年1月确诊的pSS-ILD患者108例,按超声心动图检测的肺动脉收缩压( SPAP)结果,依据肺动脉高压( PAH)诊断标准将其分为PAH组(26例)和非PAH组(82例),收集两组的临床资料、超声心动图、肺功能的检测结果,电话随访患者的用药、治疗及死亡情况,并行PAH组的肺动脉收缩压与肺功能指标相关性研究。结果(1)108例pSS-ILD患者中有PAH者26例(24.0%),PAH组中SPAP为35~82 mmHg,平均(56.8±9.2) mm-Hg,PAH的发生与患者年龄、性别、病程无关。(2) PAH组FVC%、TLC%、DLCO%较非PAH组降低( P<0.05),肺动脉收缩压与FVC%、TLC%、DLCO%呈负相关,与FEV1/FVC无相关性。随访12月后PAH组再入院率、死亡率较非PAH组升高。结论 pSS-ILD患者合并肺动脉高压后,肺功能减退明显,预后较差。定期对患者行超声心动图和肺功能检查对诊断PAH以进行早期治疗非常必要。
목적：탐토합병간질성폐병( ILD)적원발성간조종합정( pSS)환자폐동맥압력변화급기여폐공능、예후적관계。방법분석남경시고루의원급남경고루의원집단숙천시인민의원2009년1월지2013년1월학진적pSS-ILD환자108례,안초성심동도검측적폐동맥수축압( SPAP)결과,의거폐동맥고압( PAH)진단표준장기분위PAH조(26례)화비PAH조(82례),수집량조적림상자료、초성심동도、폐공능적검측결과,전화수방환자적용약、치료급사망정황,병행PAH조적폐동맥수축압여폐공능지표상관성연구。결과(1)108례pSS-ILD환자중유PAH자26례(24.0%),PAH조중SPAP위35~82 mmHg,평균(56.8±9.2) mm-Hg,PAH적발생여환자년령、성별、병정무관。(2) PAH조FVC%、TLC%、DLCO%교비PAH조강저( P<0.05),폐동맥수축압여FVC%、TLC%、DLCO%정부상관,여FEV1/FVC무상관성。수방12월후PAH조재입원솔、사망솔교비PAH조승고。결론 pSS-ILD환자합병폐동맥고압후,폐공능감퇴명현,예후교차。정기대환자행초성심동도화폐공능검사대진단PAH이진행조기치료비상필요。
Objective To investigate the change of pulmonary arterial pressure in interstitial lung disease ( ILD) patients with primary Sjogren's syndrome ( pSS) and its correlation to lung function and prognosis. Methods From January 2009 to January 2013, 108 patients with pSS-ILD were detected by color Doppler echocardiography. According to the criteria for the diagnosis of PAH, 108 patients were divided into the PAH group (n=26) and the non-PAH group (n=82). The clinical data, lung function and ultrsonic cardiogram detection results were collected, and the correlation between pulmonary artery systolic pressure and lung function was analyzed in the PAH group. Their baseline data and therapies were recorded at one year follow-up. Results ( 1 ) The incidence of PAH was 24. 0% in 108 pSS-ILD patients. The values of SPAP were 35 mmHg to 82mmHg in the PAH group, and the average was (56. 8 ± 9. 2) mmHg. The occurrence of PAH was not related to patient's age, gender and course. (2) The PAH group had lower FVC%pred, TLC%pred and DLCO%pred compared with those of the non-PAH group. In the PAH group, SPAP had positive correlation with FVC%pred, TLC%pred, DLCO%pred and no correlation with FEVl/FVC. A significantly higher incidence of re-hospitalization and mortality was observed in the PAH group. Conclusion In the PAH group, their lung function declines significantly, PAH is an important factor related to the prognosis of pSS-ILD, people should be performed lung function and ultrasonic echocardiogram after the diagnosis, which is im-portant for early diagnosis and treatment.