Effect of glucocorticoid monotherapy on pulmonary function and survival in Japanese patients with scleroderma-related interstitial lung disease
Effect of glucocorticoid monotherapy on pulmonary function and survival in Japanese patients with scleroderma-related interstitial lung disease
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DOI：
10.1016/j.resinv.2012.12.002
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发表时间：
2013-06-01
影响因子：
3.1
通讯作者：
Takahashi, Kazuhisa
中科院分区：
文献类型：
--
作者：
Ando, Katsutoshi;Motojima, Shinji;Takahashi, Kazuhisa
背景：硬皮病相关间质性肺疾病(SSC-ILD)是一种以限制性呼吸机缺陷为特征的慢性进行性疾病。无论加或不加糖皮质激素，环磷酰胺(CyC)均可有效改变SSC-ILD的病程。方法：将71例SSc-ILD患者分为两组：治疗组21例(糖皮质激素单一治疗14例或免疫抑制剂治疗7例)，非治疗组50例。对其发病背景和预后进行回顾性分析。我们还将这些患者分为生存组(n=55)和死亡组(n=16)，以评估预后因素。结果：中位随访时间为9.8年。与非治疗组相比，治疗组出现弥漫性系统性硬化症或呼吸道症状的患者比例更高。治疗组用力肺活量(FVC)年变化值为170.4毫升(糖皮质激素单一治疗组为157.8毫升，免疫抑制剂组为191.3毫升)，优于非治疗组的-60.8毫升(P<0.05)。
Background: Scleroderma-related interstitial lung disease (SSc-ILD) is a chronic, progressive condition that is characterized by a restrictive ventilator defect. Cyclophosphamide (CYC), with or without glucocorticoid, effectively alters the course of SSc-ILD. However, the effect of glucocorticoid monotherapy remains unclear.Methods: Seventy-one patients with SSc-ILD were classified into 2 groups: 21 in the treatment group (glucocorticoid monotherapy [n=14] or immunosuppressive agents [n=7]) and 50 in the non-treatment group. Their backgrounds and prognoses were analyzed retrospectively. We also classified these patients into survival (n=55) and non-survival (n=16) groups to assess prognostic factors.Results: The median follow-up period was 9.8 years. The treatment group had a greater proportion of patients with diffuse systemic sclerosis or respiratory symptoms than the non-treatment group. The treatment group's annual change in forced vital capacity (FVC) compared to baseline, which was 170.4mL (157.8mL for the glucocorticoid monotherapy subgroup and 191.3mL for the immunosuppressive agent subgroup), was better than that of the non-treatment group, -60.8mL (p