Investigation Of Clinical And Serum Characters In Primary Sj?gren's Syndrome With Interstitial Lung Disease

Objective: Primary Sj?gren's syndrome(pSS)with interstitial lung disease(ILD)has a high mortality rate,but the specific diagnostic indicators is absent in early stage and the pathogenesis is still unknown.This paper mainly discusses the clinical characteristics and serum index of patients in pSS with ILD,so as to provide more evidence for the diagnosis,treatment and prognosis of disease.Methods: Collected the data of the patients meeting the American College of Rheumatology(ACR)classification criteria for Sj?gren's syndrome,who were admitted to the immunology and rheumatology department of the Second Hospital of Hebei Medical University from October 2016 to December 2019,further to analyze their general characteristics,clinical manifestation and laboratory examination.The patients were divided into pSS with ILD group and pSS without ILD group according to with or without ILD.Results:1.The mean age of onset in the pSS with ILD group was 53.36±12.65 years versus 43.53±12.82 years in the pSS without ILD group.There was statistically difference between the two groups(P < 0.05),and no difference between the two groups in terms of gender and disease course(P > 0.05).2.Raynaud's?phenomenon(RP)occurred in 18 cases(20.00%)in the pSS with ILD group and 22 cases(10.43%)in pSS without ILD,Coughing in pSS with ILD and without ILD were 12 cases(13.33%)versus 4 cases(1.90%),19 cases(21.11%)had chest tightness and shortness of breath In the pSS with ILD group and 6 cases(2.84%)were found the same symptom in pSS without ILD group.There was statistically difference between the two groups(P < 0.05);But these symptoms including dry mouth,dry eyes,dental caries,parotid gland enlargement,joint muscle pain and skin purpura had no statistical difference between these two groups(P > 0.05).3.The difference of blood system involvement was found between the two groups(P < 0.05),21 cases(23.33%)versus 104 cases(49.29%)in the pSS with ILD group and pSS without ILD group.There was no statistically difference between the two groups about nervous systems involvement,urinary systems involvement and digestive systems involvement(P > 0.05).4.The white blood cell counts and platelet counts were separately 5.7±2.95(×10~9/L)and 207.47±90.33(×10~9/L)in the pSS with ILD group.And they were 4.92±2.71(x10~9/L)and 171.81±96.25(x10~9/L)in pSS without ILD group.The difference existed between these two groups(P < 0.05);AST,ALT,bilirubin and serum creatinine had no statistically difference between the two groups(P > 0.05).5.The mean values of ESR and CRP were respectively 45.98±30.97(mm/h)and 5.25(mg/L)in pSS with ILD group,their level were respectively 44.05±33.17(mm/h)and 2.68(mg/L)in pSS without ILD group.There was difference for CRP(P < 0.05),and no statistically difference in ESR(P > 0.05)between these two groups.6.The positive patients of anti-SSA52 KD,anti-SSA60 KD and anti-U1 RNP antibody were respectively 58 cases(64.44%),64 cases(71.11%)and 20 cases(22.22%)in the pSS with ILD group;and the positive objects of anti-SSA52 KD,anti-SSA60 KD and anti-U1 RNP antibody were 161 cases(76.30%),175 cases(82.94%),24 cases(11.37%)in pSS without ILD.There was significant difference between these two groups(P < 0.05).Other auto-antibodies,such as anti-nuclear antibody(ANA),anti-SSB antibody,anti-cardiolipin antibody(ACL),rheumatoid factor(RF),immunoglobulin(Ig)G,had no difference between two groups(P > 0.05).7.There was no difference between the two groups for labial gland biopsy(P > 0.05).Fifty patients were positive(89.29%)in 56 cases of pSS with ILD,and 129 cases were positive in pSS patients without ILD(87.76%).8.Further to analyze the correlation,RP was positively correlated with anti-U1 RNP antibody(r=0.323,P=0.013),and anti-SSA52 KD antibody was positively correlated with anti-SSA60KD(r=0.418,P=0.000)within pSS with ILD group.9.Logistic regression analysis showed that aged patients over 60 years old(OR=7.463,P=0.000),and positive anti-U1 RNP antibody(OR=3.195,P=0.004)were independent risk factors of pSS patients with ILD.Conclusions:1.The onset age of pSS patients with ILD was older than that of with pSS patients without ILD.ILD had a higher tendency in the elder person more than 60 years.2.pSS patients with ILD were more likely to have RP and respiratory symptoms such as cough,chest tightness and shortness of breath when compared with patients without ILD.3.The level of CRP was higher in pSS with ILD than that of patients without ILD.pSS Patients with ILD tend to have abnormal inflammatory markers.4.Anti-U1 RNP antibody was more likely to appear in patients with pSS with ILD,and anti-U1 RNP antibody is related to RP.The positive rate of anti-SSA52/60 kD antibody was lower in pSS patients with ILD.5.Aged patients over 60 years old and positive anti-U1 RNP antibody were independent risk factors of pSS patients with ILD.