Expresión de la neumopatía intersticial en pacientes cubanos con esclerosis sistémica

La neumopatia intersticial (NI) se presenta frecuentemente en pacientes con esclerosis sistemica (ES) y ocasiona morbilidad y mortalidad significativas. Se realizo un estudio descriptivo, prospectivo con 46 pacientes, que cumplieron criterios del Colegio Americano de Reumatologia, para identificar las formas de expresion y deteccion de la NI. Se estimo porcentajes, analisis univariable para medidas de centralizacion, dispersion y pruebas de significacion estadistica chi cuadrado (X2). Se hallo una edad media de 50,4 anos, predominio femenino (88 por ciento), color de piel blanco (66 por ciento), tuvieron neumopatia intersticial 20 pacientes (43,4 por ciento); disnea de esfuerzo, el 100 por ciento de los casos, lo cual fue estadisticamente significativo (p=0,02). La funcion respiratoria estuvo afectada en el 75 por ciento de los enfermos. Segun tomografia computadorizada de alta resolucion (TC) de pulmon, 50 por ciento tuvo patron en vidrio esmerilado y 50 por ciento, patron en panal de abejas, 66 por ciento de los pacientes con NI tuvieron lavado broncoalveolar activo y de ellos, 88 por ciento correspondio a los que tenian patron en vidrio esmerilado. Se concluyo que la neumopatia intersticial se expreso en un alto porcentaje de pacientes, la disnea de esfuerzo fue el sintoma mas frecuente, predomino el patron restrictivo. La TC y el estudio citologico del lavado broncoalveolar constituyeron herramientas clave para el diagnostico precoz de NI. Interstitial pneumopathy (IP) usually appears in patients with systemic sclerosis (SS) and causes significant morbidity and mortality. A descriptive and prospective study was conducted among 46 patients that fulfilled the criteria of the American Rheumatology College to identify the forms of expression and detection of IP. Percentages were estimated, and the univariable analysis for centralization and dispersion measurements and the chi square tests (X2) of statistical significance were used. A mean age of 50.4 years old was found. A prevalence of females (88 percent) and of white individuals (66 percent) was observed. 20 patients (43.4percent) had interstitial pneumopathy, whereas 100 percent of the cases presented effort dyspnea, which was statistically significant (p=0.02). The respiratory function was affected in 75 percent of the sick. According to high resolution computerized tomography of the lung, 50 percent had ground glass pattern and 50 percent honeycomb pattern, 66 percent of the patients with IP had active bronchoalveolar lavage and of them, 88 percent corresponded to those with ground glass pattern. It was concluded that interstitial pneumopathy was expressed in a high percentage of patients. Effort dyspnea was the most frequent symptom and the restrictive pattern predominated. CAT and the cytological study of bronchoalveolar lavage were key tools for the early diagnosis of IP.