Clincal Analysis Of Primary Sjogren’s Syndrome Lung Diseases

ObjectiveRetrospective analysis of clinical features of patients with Primary Sjogren’s syndrome complicated with interstitial pneumonia,as well as factors related to the degree of pulmonary fibrosis.MethodsFrom January 2013 to January 2019,87 patients with Primary Sjogren’s syndrome from the second affiliated hospital of zhejiang university school of medicine were included,with the exclusion of rheumatoid arthritis,systemic lupus erythematosus,dermatomyositis,scleroderma and other rheumatic diseases.There are 49 Primary Sjogren’s syndrome patients without interstitial pneumonia,38 pSS patients with interstitial pneumonia.The clinical manifestations and laboratory test results,HRCT of those patients were analyzed.ResultspSS-ILD patients were at age of 57.36±11.50 on average,fifteen were older than or equal to 60,While pSS without ILD patients were at the average age of 46.61±10.37,seven were older than 60 years or equal to it.Eighteen of pSS-ILD patients had cough and sputum and eighteen presented chest tightness and shortness of breath.however five of pSS without ILD patients showed cough and sputum,and two presented chest tightness and shortness of breath,This indicated that respiratory clinical manifestations are more common in pSS-ILD group.In patients pSS-ILD group,extrapulmonary manifestations such as caries,joint swelling and pain,and blood system involvement appeared on 2 cases,5 cases,and 9 cases respectively,which was significantly less than those with pSS without interstitial lung.There were 12 cases,16 cases,and 22 cases,respectively.Laboratory test result showed white blood cells(6.69±3.21)X109/L,neutrophil(4.70±3.35)X109/L,C3(1.00±0.26)g/L,C4(241.42±104.37)mg/L,ESR(38.71±25.19)mm/h,in pSS-ILD group.White blood cells(4.90±1.82)109/L,neutrophil(3.17±1.62)109/L,C3(0.93±0.18)g/L,C4(198.65±67.93)mg/L,ESR(26.18±17.36)mm/h.White blood cells,neutrophil,C3,C4 and ESR are higher in pSS-ILD group than in pSS without ILD group.In ILD group,IgG was 15.32±4.67g/L and the positive rate of anti-SSA antibody was 71.1%,but the IgG was 15.32±4.67g/L and the positive rate of anti-SSA antibody was 89.9%in non-ILD group.The image analysis of High resolution computed tomography score is 3.905±2.195,ground glass attenuation score is 1.615±1.271,grid change score is 1.600±0.783,honeycombing score is 0.640±0.733,HRCT scores are related to albumin,CRP,DLCO,it can be used to assess the degree of pneumonia fibrosis(P<0.05,statistic significance).Conclusion1.Patients with Primary Sjogren’s syndrome complicated with interstitial pneumonia have a higher age of onset,and are more common in elderly people older than 60 years old.They are more likely to have cough,expectoration,and chest tightness and shortness of breath.2.Leukocytes and neutrophils,C3,C4,and ESR of pSS-ILD patients are relatively higher and the positive rates of IgG and anti-SSA antibodies are decreased.3.Patients with interstitial pneumonia had decreased albumin,DLCO,and elevated CRP,suggesting a higher degree of pulmonary fibrosis.