系统性红斑狼疮患者肺部影像学特征与疾病活动度相关性研究

Correlation between imaging characteristics and activity of interstitial lung disease in systemic lupus erythematosus

摘要:

目的 探讨系统性红斑狼疮合并间质性肺病的CT特征与疾病活动度的相关性。方法 纳入131例系统性红斑狼疮相关间质性肺病患者。分析其疾病活动度评分、影像学特征及高分辨CT（high resolution computed tomography，HRCT）肺间质纤维化Kazerooni评分。采用Spearman秩和相关系数检验分析各评分之间的相关性。结果 Kazerooni评分法中的磨玻璃评分与系统性红斑狼疮疾病活动度-2000评分（systemic lupus erythematosus disease activity index-2000，SLEDAI-2000）呈正相关，差异有统计学意义（r_s=0.388，P<0.001）。而纤维化评分与SLEDAI-2000评分之间差异无统计学意义（P=0.837）。弥漫性肺泡损伤（diffuse alveolar damage，DAD）组磨玻璃评分得分最高，寻常型间质性肺炎（usual interstitial pneumonia，UIP）组纤维化评分得分最高，差异有统计学意义（均P<0.001）。比较不同间质性肺病（interstitial lung disease，ILD）类型之间SLEDAI-2000评分差异无统计学意义（P>0.05）。结论 胸部HRCT可有助于更全面地评估系统性红斑狼疮疾病情况，对制定治疗方案具有重要意义。

Abstract:

Objective To investigate the correlation between CT features and activity of interstitial lung disease associated with systemic lupus erythematosus.Methods A total of 131 patients with interstitial lung disease in systemic lupus erythematosus were included for analysis of disease activity score，imaging features，and Kazerooni score for pulmonary interstitial fibrosis based on high-resolution computed tomography. The Spearman’s rank correlation coefficient test was used to analyze the correlations between the scores.Results The ground glass opacity score in the Kazerooni scoring system was positively correlated with the systemic lupus erythematosus disease activity index-2000（SLEDAI-2000），and the correlation was statistically significant（r_s=0.388，P<0.001）. There was no significant correlation between Kazerooni fibrosis score and SLEDAI-2000（P=0.837）. The ground glass opacity score was the highest in the diffuse alveolar damage group，the fibrosis score was the highest in the usual interstitial pneumonia group，and the differences were significant（both P<0.001）. There was no significant difference in SLEDAI-2000 between different types of interstitial lung disease（P>0.05）.Conclusion Chest high-resolution computed tomography can help to comprehensively evaluate systemic lupus erythematosus and has great significance for formulation of treatment plans.