Retrospective Analysis Of 126 Cases Of Systemic Sclerosis And Its Associated Interstitial Lung Disease

Objective:To retrospectively analyse the general clinical data,first symptoms,clinical manifestations and laboratory indices of patients with systemic sclerosis and its associated interstitial lung disease who were first admitted to the Department of Dermatology and the Department of Rheumatology and Immunology of the First Affiliated Hospital of Dali University from January 2013 to December 2022,to explore the clinical features of systemic sclerosis and its associated interstitial lung disease disease characteristics and independent risk factors for its occurrence,to improve The aim is to discuss the clinical features of systemic sclerosis and its associated interstitial lung disease and the independent risk factors for its occurrence,to improve the understanding of systemic sclerosis and its associated interstitial lung disease among medical practitioners,to provide clinical practitioners with more experience in the treatment and management of such patients.Methods:A total of 126 patients with SSc who were first hospitalized and diagnosed in the Department of Dermatology and Department of Rheumatology and Immunology in the First Affiliated Hospital of Dali University from January 2013 to December 2022 were included in this study,and were divided into patients in the SSc-ILD(Systemic sclerosis with associated interstitial lung disease)group and patients in the SSc-NILD(Systemic sclerosis with no associated interstitial lung disease)group according to whether or not they had associated interstitial lung disease,and the general clinical data,first symptoms,clinical manifestations and test index results between the two groups were Comparative analysis was performed.The data were expressed in the form of mean ±standard deviation for normally distributed measures,and the t-test was used for comparison between the two groups;the data were expressed in the form of median and interquartile range M(P25～P75)for measures that did not conform to normal distribution,and the Mann Whitney U-test was used for comparison between the two groups;the data were expressed in the form of frequency and percentage for counting data,and the X~2(chi-square)test was used for comparison between the two groups.The theoretical frequencies of 1 ≤ T < 5 were corrected for formulae using the chi-square test and the theoretical frequencies of T < 1 were statistically analysed using Fisher’s exact probability method;variables that were statistically significant(p<0.05)were included in a multi-factor logistic regression to determine independent risk factors for patients with SSc-ILD,with all results indicating statistically significant differences at p<0.05.Data were analysed using SPSS 26.0 statistical software.Results:1.General clinical data: 126 patients with SSc,age range 17-69 years,mean age48.46±9.81 years,mean age of onset 46.10±10.80 years,median disease duration 1.0(0.5,4.0)years,of which 54 were male patients,accounting for 42.9% of the total population,72 were female patients,accounting for 57.1% of the total population,male:female ≈ 1:1.33.≈ The occupation of the patients was mainly farmers,accounting for 85.7% of the study population,and the ethnic groups were mainly Han,Bai and Yi,accounting for 37.3%,24.6% and 23.0% of the total population respectively.26(20.6%)of the SSc patients had a history of alcohol consumption and 37(29.4%)had a history of Smoking.69.0% of the patients.There were 57 patients(45.24%)in the SSc-ILD group and 69 patients(54.76%)in the SSc-NILD group.48 patients(84.2% of the patients in the SSc-ILD group)had dc SSc in the SSc-ILD group and 43 patients(62.3% of the patients in the SSc-NILD group)had dc SSc in the SSc-NILD group.The difference was statistically significant(P=0.006<0.05).2.first symptoms: skin swelling/sclerosis(50.8%)was the most common first symptom in SSc patients,followed by Raynaud’s phenomenon(31.7%),arthralgias(27.0%),clenched fist(13.5%),pruritus/numbness(7.9%),pigmentation abnormalities(5.5%),mask face(1.6%)and finger end ulcers(1.6%).The difference in first symptoms between patients in the SSc-ILD and SSc-NILD groups was not statistically significant(p=0.006<0.05).3.Clinical symptoms: Clinical symptoms in SSc patients were commonly associated with skin swelling/sclerosis(88.9%),joint/muscle pain(48.4%),with the rest being Raynaud’s phenomenon(47.6%),pigmentation abnormalities(47.6%),itching/pain/numbness(36.5%),palpitations/chest tightness/shortness of breath(31.0%),restricted joint movement(30.2%),cough/cough(21.4%),dysphagia/foreign body sensation(18.3%),nausea/acid reflux/distension/abdominal pain/diarrhoea(14.3%),fingertip ulcers(13.5%),weakness(6.3%),capillary dilation(4.0%)and joint contracture(3.2%).Skin swelling/sclerosis(P=0.029),cough/coughing(P=0.037),palpitations/chest tightness/shortness of breath(P=0.038),Raynaud’s phenomenon(P=0.036),and dysphagia/foreign body sensation(P=0.033)were more frequent in the SSc-ILD group than in the SSc-NILD group,with statistically significant differences(P<0.05).4.Laboratory indices: ESR and CK-MB of SSc patients were all higher than the normal range,and the positive rates of autoantibodies in SSc were,in descending order,anti-ANA antibody(86.5%),anti-scl-70 antibody(46.8%),anti-SSA(9.5%),anti-SSB and anti-Sm(2.4%).within the normal range.In the SSc-ILD group,CRP and ESR were higher than those in the SSc-NILD group,and the difference was statistically significant(P < 0.05);in the SSc-ILD group,ALB was lower than that in the SSc-NILD group,and the difference was statistically significant(P < 0.05);in the SSc-ILD group,scl-70 was significantly higher than that in the SSc-NILD group,and the difference was statistically significant(P < 0.05)..5.Multi-factor logistic regression analysis: dc SSc,cough/cough,and positive anti-scl-70 were independent risk factors for the development of SSc-ILD,and the difference was statistically significant(P < 0.05).Conclusions:1.Patients with SSc are mostly middle-aged farmers,with a male to female sex ratio of 1:1.33 and a median disease duration of 1.0 years.Skin involvement is more common in patients with dc SSc;skin involvement is more common in the SSc-ILD group than in the SSc-NILD group with dc SSc type.2.The first symptoms of SSc patients were mostly pruritus/swelling/sclerosis of the skin,Raynaud’s phenomenon and arthralgias;there was no significant difference in the first symptoms between the SSc-ILD group and the SSc-NILD group.3.Clinical symptoms in SSc patients were more common in skin swelling/sclerosis and joint/muscle pain;SSc-ILD group was more common than SSc-NILD group in clinical symptoms of skin swelling/sclerosis,cough/cough,palpitation/chest tightness/shortness of breath,Raynaud’s phenomenon and dysphagia/foreign body sensation.4.ESR and CK-MB were higher than the normal range in SSc patients,and autoantibodies were more common in the SSc-ILD group than in the SSc-NILD group,with positive anti-ANA and anti-scl-70 antibodies;CRP and ESR were higher,ALB was lower and positive scl-70 antibodies were more common in the SSc-ILD group than in the SSc-NILD group.5.dc SSc,cough/cough and anti-scl-70 positivity are independent risk factors for patients with SSc-ILD.