Clinical Analysis Of Primary Sj?gren Syndrome With Pulmonary Involvement

Objective:To study the pulmonary involvement and clinical indicators of patients with Primary Sj?gren syndrome,and provide reference for clinical diagnosis and treatment.Methods: A retrospective analysis of the hospitalized patients from January 2015 to June 2017 in rheumatology who were diagnosed of primary Sj?gren’s syndrome(p SS),Collect the patient’s lung HRCT,lung function,heart ultrasound results,as well as ESR,complement,immunoglobulin,rheumatoid factor,rheumatoid antibody series and other test indicators,use ESSDAI to assess the patient’s disease activity.Analysis the type of lung involvement types,conduct a single factor analysis and risk factor analysis.Results: According to the results of the examination in 106 cases,103 were women.The older the age,the higher the ESSDAI score.Patients with dry mouth and dry eyes as the first clinical symptom accounted for 31.13%.Of the 8 patients who presented with shortness breath,7 combined with ILD.The main changes in the lungs were ground glass(34.9%),pulmonary nodules(34.9%),and pleural thickening(25.5%).Pulmonary involvement was mainly divided into interstitial lung disease(42.5%),pulmonary hypertension(13.2%),pleural effusion(2.8%),pulmonary embolism(0.9%),and non-Hodgkin’s lymphoma(0.9%).Patients with interstitial lung disease were older,and had higher level of ESR,Ig G,and Ig A,higher positive rates for Ro-52 and AMA-M2,and lower level of RBC and HGB.13.2% of patients had pulmonary hypertension,mostly were moderate to severe,and serum Ig A levels were higher.Conclusion: Interstitial lung disease is the main form of lung involvement in patients with p SS.In patients with ILD,aging is a risk factor.Patients with p SS-ILD are more likely to have involvement in the blood system.When patient is positive for Ro-52 and / or AMA-M2 antibodies,pay attention to the possibility of combining ILD.Elevated Ig A is a risk factor for pulmonary hypertension in patients with p SS.Activation of autoimmunity plays an important role in the pathophysiological mechanisms of p SS-ILD and p SS-PAH.