干燥综合征并发间质性肺疾病患者临床特征及其危险因素分析

doi:10.13481/j.1671-587X.20230614

Abstract

Abstract:

Objective To analyze the clinical characteristics and risk factors of the patients with primary Sjogren’s syndrome （pSS） complicated with interstitial lung disease （ILD）， and to improve the clinicians’understandings of the disease， and to provide the evidence for the early detection of extradular organ involvement by the clinicians. Methods The clinical characteristics of 176 patients with pSS were collected and were divided into pSS complicated with ILD group （n=21） and pSS complicated without ILD group （n=155） according to whether the patients were complicated with ILD.The levels of hemoglobin （Hb）， white blood cells （WBC）， platelets （PLT）， C-reactive protein （CRP）， erythrocyte sedimentation rate （ESR），rheumatoid factor （RF），immunoglobulin G （IgG），immunoglobulin M （IgM），immunoglobulin A （IgA）， complement 3 （C3）， complement 4 （C4）， and the positive rates of granular type antinuclear antibodies， cytoplasmic granular type antinuclear antibodies， homogeneous type antinuclear antibodies， anti-SSA， anti-SSB， and anti-Ro-52 antibodies of the patients in two groups were compared.Univariate and multivariate Logistic regression analysis were used to analyze the clinical characteristics and laboratory indexes of the pSS patients complicated with ILD. Results Among the 176 pSS patients， the ratio of male to female was 1∶28， with the median age of 49 （39－58） years and the median course of 24 （24－48） months. Compared with pSS complicated without ILD group，the age of the patients in ILD group was older （P<0.01）， and the level of ESR was increased（P<0.01），the positive rates of cytoplasmic granular type antinuclear antibody and anti-Ro-52 antibody were increased （P<0.01）. The multivariate Logistic regression analysis results showed that the increasing of ESR level （OR=1.046，95% CI： 1.026－1.066， P=0.001） and positive granulosa type （OR=4.676，95% CI： 1.156－18.916， P=0.031） were the risk factors for ILD complicated with pSS. Conclusion The patients with pSS complicated by ILD have an older onset age and higher ESR levels； ILD is more likely to occur when the cytoplasmic granular type antinuclear antibody and anti-Ro-52 antibody of the patients are positive； the increasing of the ESR level and positive coated granular type antinuclear antibody are the risk factors for the pSS complicated with ILD.

Key words: Sjogren’s syndrome, Interstitial lung disease, Anti-Ro52 antibody, Risk factor, Erythrocyte sedimentation rate

CLC Number:

R593.2

Xiunan FENG,Lu CHEN,Yu LONG,Zhenyu JIANG,Ling ZHAO. Analysis on clinical characteristics and risk factors of patients with Sjogren’s syndrome complicated with interstitial lung disease[J].Journal of Jilin University(Medicine Edition), 2023, 49(6): 1513-1518.

Figures/Tables 4

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References 27

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Group	n	Course of disease(month)	Age(year)	Femal [n(η/%)]	Hypertension [n(η/%)]	Diabetes [n(η/%)]	Smoking [n(η/%)]	Drinking alcohol [n(η/%)]
pSS complicated with ILD	21	24(4.5,36.0)	56(52.50,6.00)	21(100.0)	5(23.8)	1(4.8)	1(4.8)	1(4.8)
pSS complicated without ILD	155	24(5.0,60.0)	47(38.00,58.00)	149(96.1)	22(14.2)	1(0.6)	6(3.9)	1(0.6)
z/χ²		－0.813	－3.023	1.000	0.328	0.324	<0.01	0.329
P		0.416	<0.01	0.460	0.199	0.569	1.000	0.566

Group	n	HB [ρ_B/（g·L^－1)]	WBC (×10⁹ L^－1)		PLT (×10⁹ L^－1)		ESR （mm·h^－1）		CRP [ρ_B/(mg·L^－1)]		RF [λ_B/(IU·mL^－1)]
pSS complicated with ILD	21	115（106.5，128.0）	4.83（3.41，6.13）		211.62±87.32		112.0（69，127）		3.30（3.02，17.18）		12.6（11.0，44.7）
pSS complicated without ILD	155	117（108.0，128.0）	4.20（3.23，5.67）		190.94±88.34		36.5（19，57）		3.14（2.05，3.85）		13.1（11.0，63.1）
z/t		－0.032	－0.833		1.008		－5.610		－1.755		－0.612
P		0.975	0.405		0.315		0.001		0.079		0.541
Group	n	IgM[ρ_B/（g·L^－1)]		IgA[ρ_B/（g·L^－1)]		IgG[ρ_B/（g·L^－1)]		C3[ρ_B/（mg·L^－1)]		C4[ρ_B/（mg·L^－1)]
pSS complicated with ILD	21	1.41（0.90，2.08）		2.73（0.98，3.87）		19.60（13.65，24.25）		0.98（0.80，1.27）		0.20（0.15，0.27）
pSS complicated without ILD	155	1.21（0.88，1.74）		3.28（2.48，4.50）		19.10（15.20，24.20）		1.00（0.83，1.17）		0.19（0.14，0.25）
z/t		－1.146		－1.394		1.008		－0.256		－0.539
P		0.252		0.163		0.953		0.789		0.590

Group	n	Grain type antinuclear antibody(+)	Cytoplasmic granules type antinuclear antibody(+)	Homogeneous type antinuclear antibody(+)	Anti-SSA antibody(+)	Anti-SSB antibody(+)	Anti-Ro52 antibody(+)
pSS complicated with ILD	21	11（52.4）	11（52.4）	2（9.5）	21（100.0）	11（52.4）	14（66.7）
pSS complicated without ILD	155	115（74.2）	21（13.5）	32（20.6）	138（89.0）	78（50.3）	53（34.2）
z		0.073	16.230	0.841	1.148	0.031	8.272
P		0.787	<0.01	0.359	0.119	0.859	<0.01

Risk factor	Univariate analysis		Multivariate analysis
Risk factor	OR(95%CI)	P	OR(95%CI)	P
Age	1.058(1.016－1.102)	0.006	1.044(0.914－0.987)	0.132
ESR	1.054(1.034－1.074)	<0.01	1.046(1.026－1.066)	0.001
Cytoplasmic granules type antinuclear antibody(+)	7.019(2.655－18.555)	<0.01	4.476(1.560－18.916)	0.031
Anti-Ro52 antibody(+)	3.849(1.465－10.114)	0.006	2.792(0.772－10.102)	0.118

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Analysis on clinical characteristics and risk factors of patients with Sjogren’s syndrome complicated with interstitial lung disease

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