A Clinical Research Of 86 Patients With Interstitial Lung Disease In Primary Sj(?)gren's Syndrome

Objective: To explore the clinical features,risk factors and efficacy of primary sjogren's syndrome associated with interstitial lung disease.Methods: Retrospective analysis of Hospital diagnosis and treatment of 86 patients with primary Sj(?)gren's syndrome associated interstitial lung disease as the observation group from January 2006 to December 2016 in the first affiliated hospital of Guang Xi Medical University,in the same period,the hospitalized patients were randomly selected on 1: 1 ratio of non-interstitial lung disease,86 patients with Sjogren's syndrome were used as the control group,to analyze the clinical characteristics of the two,while discuss the efficacy and related risk factors of both.Results:1.There were 86 primary Sj(?)gren's syndrome patients associated interstitial lung disease in the observation group,including 18 males(20.9%),68 were women(79.1%),the age span of 19 to 89 years,average age(61.19 ± 12.58)yearss.The duration was from 0.25 to 360 months,and the average duration For(9.5,34.00)months.The age of onset and the old age(?65 years)in the observation group was higher than that in the control group(?65 years),andthere was significant difference(P <0.05).2.Comparison of the clinical features,the observation group fever,cough,sputum,skin / vasculitis change,Velcro rales are more common in the control group,as the first symptom of dry mouth compared with the control group less(P <0.05).Also observed the course of systemic involvement,observation population respiratory system,systemic nervous is the more common than in the control group,the differences were statistically significant(P <0.05).3.Analyzing the laboratory examination results,the observation group Complement C3 Complement C4 levels and lower than the control group,and the erythrocyte sedimentation rate,C-reactive protein,immunoglobulin A,serum globulin control group,the differences were statistically significant(P <0.05).autoantibody spectrum test results contrast,anti-SSA antibody,anti-Ro-52 antibody positive rate higher than the control group(P <0.05).4.By Logistic regression analysis showed,p SS-ILD risk factors of elderly(? 65 years of age),with skin/vascular inflammatory change for the first symptom.According to the OR value,the risk of elderly(aged?65 years)is greater than the skin / vasculitis change.Hydroxychloroquine was the protective factor of pSS-ILD(P <0.05).5.86 cases of pSS-ILD patients,according to the ILD onset: ILD before pSS onset of 42 cases,with pSS associated with 12 cases,occurred in 32 cases after pSS onset;according to ILD imaging manifestations: 21 cases of traction bronchiectasis,14 cases of honeycomb shadow,11 cases of grid shadow,9 cases of ground glass;accordinghest chest HRCT pattern: UIP Type 26 cases,NSIP type in 43 cases,17 cases did not stereotypes.6.86 cases of pSS-ILD patients during hospitalization evaluation,effective group of 74 cases,12 cases of ineffective group.12 cases of refractory p SS-ILD,and 4 deaths during hospitalization,mortality was 33%.Compared with the effective group,the serum albumin in the ineffective group was lower than that in the effective group.The titer of the rheumatoid factor in the ineffective group was higher than that in the effective group,the difference was statistically significant(P <0.05).7.Acute alveolar Pneumonia type and NSIP type of glucocorticoid treatment is better,glucocorticoid treatment is still the preferred treatment.Chronic progression,UIP type of glucocorticoid little effect,poor prognosis.Conclusion:1.Primary Sj(?)gren's syndrome associated interstitial lung disease in patients with older age,respiratory symptoms than pSS appear,and more common in the elderly(? 65 years).2.Comparing to the pSS patients with without ILD,patients with respiratory system,nervous system,skin / change vasculitis involvement,erythrocyte sedimentation rate,C-reactive protein,immunoglobulin G,immunoglobulin A,immunoglobulin serum levels,anti-SSA antibody,anti-Ro-52 Antibody positive rate are more common.3.The risk factors of pSS-ILD are aged?65 years,immunoglobulin G,skin /vasculitis change.