Pulmonary CT Findings In Systemic Lupus Erythematosus And Its Correlation With CRP、C3、anti-ds-DNA Antibodies、 Anti-Sm Antibodies

Objctive:The aim of this study was to assess the abnormal findings in patientswith systemic lupus erythematosus by the use of thin-section CT,and to explore thecorrelation with age,duration and serum markers (C3,CRP,anti-dsDNA antibodies,anti-Sm antibodies).Besides,attempts to the explore the pathogenesis of SLE chestlesions.Methods:From March2012to March2013,39consecutive patients with SLE inthe First Affiliated Hospital of Dalian Medical University,who met the inclusioncriteria,were enrolled into our study.All patients underwent serum laboratory tests,chestCT scan.Analysis the CT findings of each patients,includes interstitial、airway andpleural changes.To explore the correlation of CT abnormalities with the clinical date、serum laboratory parameters of each patients.Result:Chest imaging findings:Of all the39patients,36patients (92.3%) hadabnormal views,the most common changes were interstitial changes,19cases (48.7%)had pleural changes,14cases (35.9%) had airway changes. In the36interstitial cases,theinterlobular septal thickening and pleural off the assembly line were most appered,therates were separately46.2%、20.5%,which distributed in the under and outer lungfield;Ground–glass opacities and gas lacunar had the incidence of28.2%,which wereevenly disbuted.Airway diseases were more appeared as bronchiectasis,while pleuralchanges were more seen as pleural thickening(68.4%).Relationship between clinical data and CT findings: Of all the39cases,4caseswere males and the others were femals.They aged from18-79years old.Average agewere49.36±16.56years.The courses of disease were from onset to twenty years, theaverage duration of4.94±6.36years. Of the39patients, C3positive were in20cases,accounting for51.3%, CRP positive in20cases (51.3%),23cases of anti-ds-DNA antibody positive, accounting for59%, anti-Sm antibodies positive in19cases,accounting for48.7%. Airway changes or without involvement of the two groups hadanti-ds-DNA antibody positive difference; Anti-ds-DNA, C3and age, duration hadinfluential of airway involvement.Older、longer in the couses and anti-ds-DNAantibody positive were conducive to airway diseases,while C3negative conducive toairway diseases.Conclusion:1、The CT scanning directly observed the chest lesions of systemic lupuserythematosus, the findings is not specific, mainly in:○1,Interstitial lung changes wereusually seen.Early changes were ground-glass opacities (usually uniform distribution)and would exist in any stage in the course of the disease, late periods were honeycombfibrosis (more than the lower lung field, outer lung zone).○2, Pleurisy/pleural effusion:more were bilateral small amount of fluid;○3、Airway changes:more seen werebronchiectasis.2、 The duration of disease on airway lesions was statistically significant.Anti-ds-DNA, C3and age, duration were the indicators of airway invasion.Olderpatients who were later in the course、postive of C3and negative of anti-ds-DNA weremore susceptible to have airway changes.3、 ANA, anti-Sm antibodies, CRP and the presence or absence of chest lesionsdifferences in chest lesions is not as simple as kidney infiltration of immunecomplexes，Which may result from inflammatory or other more complex interactions.