[1]陈 英,周淑红,王 妍,等.硬皮病相关间质性肺病与特发性肺纤维化的临床比较[J].医学信息,2023,36(10):53-58.[doi:10.3969/j.issn.1006-1959.2023.10.013]
 CHEN Ying,ZHOU Shu-hong,WANG Yan,et al.Clinical Comparison Between Scleroderma Associated Interstitial Lung Disease and Idiopathic Pulmonary Fibrosis[J].Journal of Medical Information,2023,36(10):53-58.[doi:10.3969/j.issn.1006-1959.2023.10.013]
点击复制

硬皮病相关间质性肺病与特发性肺纤维化的临床比较()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年10期
页码:
53-58
栏目:
论著
出版日期:
2023-05-15

文章信息/Info

Title:
Clinical Comparison Between Scleroderma Associated Interstitial Lung Disease and Idiopathic Pulmonary Fibrosis
文章编号:
1006-1959(2023)10-0053-06
作者:
陈 英周淑红王 妍
(1.甘肃中医药大学第一临床医学院,甘肃 兰州 730000;2.甘肃省人民医院免疫风湿科,甘肃 兰州 730000)
Author(s):
CHEN YingZHOU Shu-hongWANG Yanet al.
(1.The First Clinical Medical College of Gansu University of Chinese Medicine,Lanzhou 730000,Gansu,China; 2.Department of Ultrasound,Gansu Provincial Hospital,Lanzhou 730000,Gansu,China)
关键词:
间质性肺疾病系统性硬化症特发性肺纤维化
Keywords:
Interstitial lung diseaseSystemic sclerosisIdiopathic pulmonary fibrosis
分类号:
R744.5+1
DOI:
10.3969/j.issn.1006-1959.2023.10.013
文献标志码:
A
摘要:
目的 比较系统性硬化症相关肺间质性病变(SSc-ILD)与特发性肺纤维化(IPF)患者的临床特点。方法 收集甘肃省人民医院2018年10月-2021年11月明确诊断为SSc-ILD和IPF患者资料,对其临床特点进行回顾性分析,并采用Praeson线性相关分析乳酸脱氢酶水平与DLCOpre%及HRCT评分的相关性,采用多因素线性回归分析影响患者肺纤维化程度的相关因素。结果 共纳入68例患者,其中SSc-ILD患者28例,IPF患者40例,SSc-ILD组的发病年龄低于IPF组,差异有统计学意义(P<0.05);SSc-ILD组多为女性,皮肤关节症状为首发表现较多,IPF组吸烟及男性患者占比较多,呼吸系统症状出现时间长,以呼吸症状为首发表现,咳嗽、咳痰、气短、乳酸脱氢酶升高,DLCO%pre降低占比高于SSc-ILD组,差异有统计学意义(P<0.05);IPF组HRCT以UIP型多见,蜂窝状影、肺纤维化评分高于SSc-ILD组,差异有统计学意义(P<0.05);SSc-ILD组HRCT以NSIP多见,纤维条索影、心包积液患者多于IPF组,差异有统计学意义(P<0.05);Praeson线性相关分析显示,LDH水平与HRCT评分呈正相关(r=0.647,P<0.05),LDH水平与DLco%pre值呈负相关(r=-0.422,P<0.05);多因素线性回归分析显示,LDH水平是肺纤维化不良预后的独立危险因素(P<0.05)。结论 SSc-ILD和IPF患者的临床特点存在显著差异,自身抗体、肺功能、HRCT在肺间质性疾病的诊断中发挥重要价值,乳酸脱氢水平与SSC-ILD患者肺纤维化严重程度高度相关,临床值得注意。
Abstract:
Objective To compare the clinical characteristics of patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD) and idiopathic pulmonary fibrosis (IPF).Methods The data of patients diagnosed with SSc-ILD and IPF in Gansu Provincial People’s Hospital from October 2018 to November 2021 were collected, and their clinical characteristics were retrospectively analyzed. The correlation between lactate dehydrogenase level and DLCOpre% and HRCT score was analyzed by Praeson linear correlation. Multivariate linear regression analysis was used to analyze the related factors affecting the degree of pulmonary fibrosis in patients.Results A total of 68 patients were included, including 28 patients with SSc-ILD and 40 patients with IPF. The age of onset in the SSc-ILD group was lower than that in the IPF group, and the difference was statistically significant (P<0.05). The SSc-ILD group was mostly female, with more skin and joint symptoms as the first manifestation. In the IPF group, smoking and male patients accounted for more, respiratory symptoms appeared for a long time, with respiratory symptoms as the first manifestation, cough, sputum, shortness of breath, lactate dehydrogenase increased, DLCO%pre decreased higher than the SSc-ILD group, the difference was statistically significant (P<0.05); the HRCT of IPF group was more common in UIP type, and the scores of honeycomb shadow and pulmonary fibrosis were higher than those of SSc-ILD group (P<0.05 ). In SSc-ILD group, NSIP was more common in HRCT, and patients with fibrous cord shadow and pericardial effusion were more than those in IPF group, the difference was statistically significant (P<0.05). Praeson linear correlation analysis showed that LDH level was positively correlated with HRCT score (r=0.647, P<0.05), and LDH level was negatively correlated with DLCO%pre (r=-0.422, P<0.05). Multivariate linear regression analysis showed that LDH level was an independent risk factor for poor prognosis of pulmonary fibrosis (P<0.05).Conclusion There are significant differences in clinical characteristics between SSc-ILD and IPF patients. Autoantibodies, lung function and HRCT play an important role in the diagnosis of interstitial lung disease. Lactate dehydrogenation level is highly correlated with the severity of pulmonary fibrosis in SSC-ILD patients, which is worthy of clinical attention.

参考文献/References:

[1]Cottin V,Brown KK.Interstitial lung disease associated with systemic sclerosis (SSc-ILD)[J].Respir Res,2019,20(1):13.[2]Denton CP,Khanna D.Systemic sclerosis[J].Lancet,2017,390(10103):1685-1699.[3]Meyer KC.Pulmonary fibrosis, part I: epidemiology, pathogenesis, and diagnosis[J].Expert Rev Respir Med,2017,11(5):343-359.[4]Araújo FC,Camargo CZ,Kayser C.Validation of the ACR/EULAR classification criteria for systemic sclerosis in patients with early scleroderma[J].Rheumatol Int,2017,37(11):1825-1833.[5]Raghu G,Remy-Jardin M,Myers JL,et al.Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline[J].Am J Respir Crit Care Med,2018,198(5):e44-e68.[6]Travis WD,Costabel U,Hansell DM,et al.An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias[J].Am J Respir Crit Care Med,2013,188(6):733-748.[7]American Thoracic Society,European Respiratory Society.American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001[J].Am J Respir Crit Care Med,2002,165(2):277-304.[8]Camiciottoli G,Orlandi I,Bartolucci M,et al.Lung CT densitometry in systemic sclerosis: correlation with lung function, exercise testing, and quality of life[J].Chest,2007,131(3):672-681.[9]Distler O,Highland KB,Gahlemann M,et al.Nintedanib for Systemic Sclerosis-Associated Interstitial Lung Disease[J].N Engl J Med,2019,380(26):2518-2528.[10]Swarnakar R,Garje Y,Markandeywar N,et al.Exploring the common pathophysiological links between IPF, SSc-ILD and post-COVID fibrosis[J].Lung India,2022,39(3):279-285.[11]Cheng JZ,Wilcox PG,Glaspole I,et al.Cough is less common and less severe in systemic sclerosis-associated interstitial lung disease compared to other fibrotic interstitial lung diseases[J].Respirology,2017,22(8):1592-1597.[12]Newton DA,Lottes RG,Ryan RM,et al.Dysfunctional lactate metabolism in human alveolar type Ⅱ cells from idiopathic pulmonary fibrosis lung explant tissue[J].Respir Res,2021,22(1):278.[13]Kishaba T,Nei Y,Momose M,et al.Clinical Characteristics Based on the New Criteria of Acute Exacerbation in Patients with Idiopathic Pulmonary Fibrosis[J].Eurasian J Med,2018,50(1):6-10.[14]Okamoto S,Tsuboi H,Noma H,et al.Predictive Factors for Pneumomediastinum During Management of Connective Tissue Disease-related Interstitial Lung Disease: A Retrospective Study[J].Intern Med,2021,60(18):2887-2897.[15]Cao M,Sheng J,Qiu X,et al.Acute exacerbations of fibrosing interstitial lung disease associated with connective tissue diseases: a population-based study[J].BMC Pulm Med,2019,19(1):215.[16]Yoo H,Hino T,Han J,et al.Connective tissue disease-related interstitial lung disease (CTD-ILD) and interstitial lung abnormality (ILA): Evolving concept of CT findings, pathology and management[J].Eur J Radiol Open,2020,8:100311.[17]Wu X,Yin C,Chen X,et al.Idiopathic Pulmonary Fibrosis Mortality Risk Prediction Based on Artificial Intelligence: The CTPF Model[J].Front Pharmacol,2022,13:878764.[18]Luppi F,Kalluri M,Faverio P,et al.Idiopathic pulmonary fibrosis beyond the lung: understanding disease mechanisms to improve diagnosis and management[J].Respir Res,2021,22(1):109.[19]Khanna D,Tashkin DP,Denton CP,et al.Etiology, Risk Factors, and Biomarkers in Systemic Sclerosis with Interstitial Lung Disease[J].Am J Respir Crit Care Med,2020,201(6):650-660.[20]Walkoff L,White DB,Chung JH,et al.The Four Corners Sign: A Specific Imaging Feature in Differentiating Systemic Sclerosis-related Interstitial Lung Disease From Idiopathic Pulmonary Fibrosis[J].J Thorac Imaging,2018,33(3):197-203.

相似文献/References:

[1]孙 杰,李 洋.系统性硬化症纤维化治疗新靶点研究[J].医学信息,2018,31(09):56.[doi:10.3969/j.issn.1006-1959.2018.09.018]
 SUN Jie,LI Yang.A New Target for the Treatment of Systemic Sclerosis with Fibrosis[J].Journal of Medical Information,2018,31(10):56.[doi:10.3969/j.issn.1006-1959.2018.09.018]
[2]冯彩云.胺碘酮导致间质性肺病患者的1例分析[J].医学信息,2018,31(10):191.[doi:10.3969/j.issn.1006-1959.2018.10.068]
[3]程丽丽,黄传兵,汤忠富,等.从肺论治系统性硬化症合并间质性肺病的经验举隅[J].医学信息,2022,35(10):155.[doi:10.3969/j.issn.1006-1959.2022.10.039]
[4]王海燕,唐小葵.系统性硬化症相关间质性肺病的治疗[J].医学信息,2018,31(19):60.[doi:10.3969/j.issn.1006-1959.2018.19.020]
 WANG Hai-yan,TANG Xiao-kui.Treatment of Systemic Sclerosis-related Interstitial Lung Disease[J].Journal of Medical Information,2018,31(10):60.[doi:10.3969/j.issn.1006-1959.2018.19.020]
[5]孟琳非,黄伟健,酆孟洁,等.基于聚类分析对慢性肺部疾病表型的研究进展[J].医学信息,2019,32(07):44.[doi:10.3969/j.issn.1006-1959.2019.07.015]
 MENG Lin-fei,HUANG Wei-jian,FENG Meng-jie,et al.Advances in Research on Phenotypes of Chronic Lung Diseases Based on Cluster Analysis[J].Journal of Medical Information,2019,32(10):44.[doi:10.3969/j.issn.1006-1959.2019.07.015]
[6]李 莘,吴 琦.经支气管冷冻肺活检在间质性肺疾病病理诊断中的应用[J].医学信息,2020,33(21):32.[doi:10.3969/j.issn.1006-1959.2020.21.010]
 LI Xin,WU Qi.Application of Transbronchial Frozen Lung Biopsy in Pathological Diagnosis of Interstitial Lung Disease[J].Journal of Medical Information,2020,33(10):32.[doi:10.3969/j.issn.1006-1959.2020.21.010]
[7]刘孟国,傅雯雯.警报素在系统性硬化症发病机制中的作用[J].医学信息,2021,34(04):40.[doi:10.3969/j.issn.1006-1959.2021.04.011]
 LIU Meng-guo,FU Wen-wen.The Role of Alarmins in the Pathogenesis of Systemic Sclerosis[J].Journal of Medical Information,2021,34(10):40.[doi:10.3969/j.issn.1006-1959.2021.04.011]

更新日期/Last Update: 1900-01-01