结缔组织病相关间质性肺病进行性肺纤维化的影响因素

IF 3.3 3区 医学 Q2 RESPIRATORY SYSTEM
Kyuhwan Kim, Jongmin Lee, Yong Suk Jo
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引用次数: 0

摘要

背景:结缔组织病(CTD)相关间质性肺疾病(ILD)可发生进行性纤维化,并使预后恶化。目的:本研究旨在探讨与ctd - ild进行性肺纤维化(PPF)表型相关的因素。设计:回顾性分析韩国一家三级医院诊断为CTD和ILD患者的医疗记录。方法:对肺功能随访1年以上的患者进行分析。PPF被定义为强制肺活量(FVC)下降小于或等于10%或一氧化碳扩散量(DLco)小于或等于15%。结果:110例CTD-ILD患者中,24.5%进展为PPF。类风湿性关节炎和干燥病占PPF的63%以上。CTD类型在PPF和非PPF之间的成分相似。PPF和非PPF的临床特征和常见间质性肺炎(UIP)在胸部图像上的比例也相似。两组中约有10%的患者接受了抗纤维化药物治疗。在调整性别、年龄、生理评分和吸烟状况后,全身性类固醇和/或其他免疫调节剂的使用降低了CTD-ILD患者发生PPF的风险(调整优势比:0.25,95%可信区间:0.07-0.85)。结论:约1 / 4的CTD-ILD进展为PPF。免疫调节剂的使用降低了发生PPF的风险。为了改善患者的预后,未来的研究需要更早地发现PPF高危患者,并在PPF过程中制定治疗策略的临床指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors for progressive pulmonary fibrosis in connective tissue disease-related interstitial lung disease.

Background: Progressive fibrosis can occur in connective tissue disease (CTD)-related interstitial lung disease (ILD) and make the prognosis worse.

Objectives: This study aimed to investigate factors related to progressive pulmonary fibrosis (PPF) phenotype in CTD-ILDs.

Design: Medical records of patients diagnosed as CTD and ILD at a single, tertiary hospital in South Korea were retrospectively reviewed.

Methods: Patients whose lung functions were followed up for more than a year were included in analysis. PPF was defined as forced vital capacity (FVC) declined ⩾10% or diffusion capacity of carbon monoxide (DLco) ⩾15%.

Results: Of 110 patients with CTD-ILD, 24.5% progressed into PPF. Rheumatoid arthritis (RA) and Sjogren's disease accounted for more than 63% of PPF. Compositions of CTD type were similar between PPF and non-PPF. Clinical characteristics and proportion of usual interstitial pneumonia (UIP) pattern on chest images were also similar between PPF and non-PPF. Approximately 10% of patients in both groups were treated with anti-fibrotic agents. Use of systemic steroids and/or other immunomodulating agents lowered the risk of developing PPF in CTD-ILD patients after adjusting for gender-age-physiology score and smoking status (adjusted odds ratio: 0.25, 95% confidence interval: 0.07-0.85).

Conclusion: About a quarter of CTD-ILD progressed into PPF. The use of immunomodulating agents lowered the risk of developing PPF. To improve outcomes of patients, future studies need to detect patients at higher risk for PPF earlier and set up clinical guidelines for treatment strategies in the process of PPF.

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来源期刊
CiteScore
6.90
自引率
0.00%
发文量
57
审稿时长
15 weeks
期刊介绍: Therapeutic Advances in Respiratory Disease delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of respiratory disease.
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