联合肺纤维化和肺气肿对结缔组织疾病和系统性硬化症患者的影响:系统回顾和荟萃分析

IF 4.4 2区 医学 Q1 RHEUMATOLOGY
Bon San Koo, Kyu Yong Park, Hyun Jung Lee, Hyun Jung Kim, Hyeong Sik Ahn, Shin-Young Yim, Jae-Bum Jun
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引用次数: 11

摘要

背景:本研究旨在系统分析文献,比较结缔组织病(CTD)合并肺纤维化和肺气肿(CPFE)患者与无肺气肿的CTD-间质性肺疾病(CTD- ild)患者的临床特点和预后。方法:检索MEDLINE、EMBASE、Cochrane Library和KoreaMed,检索2019年7月前发表的相关文章。符合以下所有标准的研究被纳入:(1)评估CPFE对CTD影响的原始研究,(2)比较CTD-CPFE患者与没有肺气肿的CTD- ild患者的研究,以及(3)提供CTD患者体能、肺功能或死亡数据的研究。比较CTD-CPFE患者与无肺气肿的CTD-ILD患者的临床特征,分析CPFE对患者体能、肺功能及死亡的影响。结果:纳入了2013年至2019年的6项研究。无肺气肿的CTD-CPFE和CTD-ILD患者分别为299例(29.5%)和715例(70.5%)。在CTD类型方面,711例(68.3%)患者为系统性硬化症,263例(25.3%)为类风湿关节炎,67例(6.4%)为其他CTD。与无肺气肿的CTD-ILD患者相比,CTD-CPFE患者出现肺动脉高压和肺纤维化的频率更高,>肺总容积的20%,强迫肺活量与肺一氧化碳弥散量(DLCO)的比值更高,静息时动脉氧压更低,DLCO更低。此外,CTD-CPFE患者的死亡率更高(优势比,2.95;95%置信区间,1.75-4.96)。结论:与没有肺气肿的CTD-ILD患者相比,CTD-CPFE患者的身体和肺功能更差,死亡率更高。这些发现表明需要提高对CTD-CPFE患者的认识和密切监测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Effect of combined pulmonary fibrosis and emphysema on patients with connective tissue diseases and systemic sclerosis: a systematic review and meta-analysis.

Effect of combined pulmonary fibrosis and emphysema on patients with connective tissue diseases and systemic sclerosis: a systematic review and meta-analysis.

Background: This study aimed to analyze the literature systematically to determine the clinical characteristics and prognosis of patients with connective tissue disease (CTD) with combined pulmonary fibrosis and emphysema (CPFE) compared to those of patients with CTD-interstitial lung disease (CTD-ILD) without emphysema.

Methods: We searched MEDLINE, EMBASE, Cochrane Library, and KoreaMed for relevant articles published before July 2019. Studies meeting all the following criteria were included: (1) original research studies evaluating the effect of CPFE on CTD, (2) studies that compared patients with CTD-CPFE to those with CTD-ILD without emphysema, and (3) studies providing data on physical capacity, pulmonary function, or death in patients with CTD. Clinical characteristics of patients with CTD-CPFE were compared with those of patients with CTD-ILD without emphysema, and the influence of CPFE on physical capacity, pulmonary function, and death was analyzed.

Results: Six studies between 2013 and 2019 were included. Two hundred ninety-nine (29.5%) and 715 (70.5%) patients had CTD-CPFE and CTD-ILD without emphysema, respectively. Regarding the type of CTD, 711 (68.3%) patients had systemic sclerosis, 263 (25.3%) rheumatoid arthritis, and 67 (6.4%) other CTDs. Patients with CTD-CPFE had a higher frequency of pulmonary hypertension and pulmonary fibrosis > 20% of the total lung volume, higher ratio of the forced vital capacity to the diffusion capacity of the lung for carbon monoxide (DLCO), lower arterial oxygen pressure at rest, and lower DLCO compared to those in patients with CTD-ILD without emphysema. In addition, more deaths occurred among those with CTD-CPFE (odds ratio, 2.95; 95% confidence interval, 1.75-4.96).

Conclusion: CTD-CPFE is associated with worse physical and pulmonary function and more deaths compared to those in CTD-ILD without emphysema. These findings indicate the need for increased awareness and close monitoring of patients with CTD-CPFE.

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来源期刊
CiteScore
8.30
自引率
2.00%
发文量
261
审稿时长
2.3 months
期刊介绍: Established in 1999, Arthritis Research and Therapy is an international, open access, peer-reviewed journal, publishing original articles in the area of musculoskeletal research and therapy as well as, reviews, commentaries and reports. A major focus of the journal is on the immunologic processes leading to inflammation, damage and repair as they relate to autoimmune rheumatic and musculoskeletal conditions, and which inform the translation of this knowledge into advances in clinical care. Original basic, translational and clinical research is considered for publication along with results of early and late phase therapeutic trials, especially as they pertain to the underpinning science that informs clinical observations in interventional studies.
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