Investigation Of Clinical Characters In Primary Sj(?)gren’s Syndrome With Interstitial Lung Disease

Objective: Patients with primary Sj(?)gren’s syndrome(pSS)complicated with interstitial lung disease(ILD)usually have poor survival and quality of life,as well as poor prognosis.In this paper,the clinical manifestations,laboratory indexes,imaging features and lung function data of patients in pSS with ILD were analyzed in order to provide more clinical evidence for the early diagnosis and treatment of patients in pSS with ILD.Methods: The clinical data of patients diagnosed with pSS in the Department of Rheumatology and Immunology of our hospital from March 2019 to May 2022 were retrospectively analyzed.According to the lung HRCT mode,the patients were divided into pSS with ILD group and pSS without ILD group.SPSS26.0 statistical software was used for statistical analysis.For all analyses,P< 0.05 was considered to be significant.Results:1.A total of 340 patients with pSS were collected,of which 145 were diagnosed with pSS-ILD.Based on pulmonary high-resolution computed tomography,patients were divided into nonspecific(n=122),usual(n=13),lymphocytic interstitial pneumonia(n = 6)and organising pneumonia(n = 4)groups.2.The mean age of pSS-ILD patients was 57.88 ± 10.90 years old,and the mean age of pSS-n ILD patients was 48.39 ± 13.79 years old,there was significantly different between the two groups(P<0.05).We found no statistically significant differences in the course of disease and gender between the two groups(P>0.05).3.Twenty cases of Raynaud’ s phenomenon in pSS-ILD group(13.8%)were higher than those in pSS-n ILD group(4.6%)(P<0.05).Regarding the presence of articalgia,caries,swollen glands and so on,we found no statistically significant difference between patients with and without ILD(P>0.05).4.Compared with pSS-n ILD patients,the ESSDAI score and ESR was higher in pSS-ILD patients(P<0.05).A higher CRP,higher Ig A and higher γ-IFN were observed in the ILD group(P<0.05).We found no statistically significant differences in RF,complement,lymphocyte subsets and other indexes(P>0.05).In addition,a lower PT,lower APTT,higher D-D and higher Fg were observed in the ILD group(P<0.05).The level of CEA and CA153 was higher in ILD group(P<0.05),there was no statistically significant differences in the level of AFP and CA125 between the two groups(P>0.05).We found no statistically significant differences in the level of WBC,NE,LY and other indexes between the two groups(P>0.05).5.According to the salivary(parotid gland and submandibular gland)single-photon emission computed tomography results,patients were divided into severe glandular damage group and wihtout severe glandular damage group.In patients with disease course less than 5 years,a higher proportion of severely impaired glandular function in patients with ILD(P<0.05).6.Compared with ILD patients with normal small airway function,the levels of FEV1 and FEV1/FVC were lower in patients with small airway dysfunction,and Ig G and Ig A were more frequently elevated(P<0.05).There were no significant differences in age,course of disease,CRP,ESR and cytokine increase between the two groups(P>0.05).Compared with subclinical pSS-ILD group(pSS-ILD patients without respiratory symptoms),patients with respiratory symptoms were older,had lower FVC and DLCO values,and were more likely to have reduced complement 3 and complement 4,and elevated CRP,IL-2,IL-10 and TNF-α(P>0.05).7.Correlation analysis showed that pSS-ILD patient’ s lung HRCT score was negatively correlated with FVC,FEV1 and DLCO,and positively correlated with CRP(P<0.05).Conclusion: ILD is a common complication of pSS and one of the main factors leading to poor prognosis.The most common mode of pSS-ILD on HRCT is NSIP.Increasing age and increased inflammatory markers are often associated with ILD.ILD screening should be performed as soon as possible for patients with Raynaud’ s phenomenon and severely impaired salivary gland function.In addition,ILD patients with elevated Ig G and Ig A levels are more likely to have small airway dysfunction,which is helpful for clinical recognition,diagnosis and treatment.