CAJ | 학술논문

目的了解类风湿性关节炎肺间质病变的发生情况、特征及相关因素分析,以便早期发现类风湿性关节炎的肺部病变.方法类风湿性关节炎患者45例,免疫比浊法检测类风湿因子、C反应蛋白、免疫球蛋白及补体;间接免疫荧光法和免疫印迹法检测抗核抗体及亚类.血气分析测定氧分压、动脉血二氧化碳分压和肺泡-动脉血氧分压差.肺功能仪测定潮气容积、最大肺活量、用力肺活量、第1秒用力呼气容积、最大呼气中段流量、最大通气量和一氧化碳弥散功能.放射学检查包括胸部正侧位X线片、双手像和肺高分辨率CT扫描.结果 45例类风湿关节患者中,14例存在肺间质病变,其中10例有呼吸道症状.肺功能检测异常主要为弥散功能降低和限制性通气障碍.8例胸部X线片存在异常,14例高分辨率CT发现异常.肺高分辨率CT在发现类风湿性关节炎肺间质病变病变时优于普通胸部X线片.结论类风湿性关节炎肺间质病变的发生与疾病活动性和严重性相关,肺弥散功能、高分辨率CT在早期发现病变时有诊断意义.
목적 료해류풍습성관절염폐간질병변적발생정황、특정급상관인소분석,이편조기발현류풍습성관절염적폐부병변.방법 류풍습성관절염환자45례,면역비탁법검측류풍습인자、C반응단백、면역구단백급보체;간접면역형광법화면역인적법검측항핵항체급아류.혈기분석측정양분압、동맥혈이양화탄분압화폐포-동맥혈양분압차.폐공능의측정조기용적、최대폐활량、용력폐활량、제1초용력호기용적、최대호기중단류량、최대통기량화일양화탄미산공능.방사학검사포괄흉부정측위X선편、쌍수상화폐고분변솔CT소묘.결과 45례류풍습관절환자중,14례존재폐간질병변,기중10례유호흡도증상.폐공능검측이상주요위미산공능강저화한제성통기장애.8례흉부X선편존재이상,14례고분변솔CT발현이상.폐고분변솔CT재발현류풍습성관절염폐간질병변병변시우우보통흉부X선편.결론 류풍습성관절염폐간질병변적발생여질병활동성화엄중성상관,폐미산공능、고분변솔CT재조기발현병변시유진단의의.
Objective To investigate the prevalence and clinical manifestation of rheumatoid arthritis-inter-stitial lung disease(RA-ILD). Methods Forty-five inpatients with rheumatoid arthritis(RA) were enrolled. Serum rheumatoid factor (RF), C reactive protein (CRP), immunoglobulin (IgG, IgA, IgM), and compliment (C3, C4) were measured by immunoncphelometry. Antinuclear antibodies (ANAs) and anti-extractable nuclear antigen(anti-ENA) antibodies were measured by indirect immunofluorescence technique and Western blot. Arterial gas analysis included PaO2, PaCO2, and PA-zO2. The following pulmonary function tests were performed: tidal volume(VT), maximal vital-capacity (Vcmax), forced vital capacity (FVC), one second forced expiratory volume (FEV1), FEV1/FVC, maximal mid-expiratory flow(MMFF), maximal voluntary ventilation(MVV) and diffusing capacity CO (DLCO). Radiology examinations included chest X radiographs, hand radiographs and chest HRCT. Results abnormal findings included interlobular septal thickening, bronchovascular bundles thickening, sub pleura] lines, re-ticular appearances, ground glass capacity and honeycomb changes. HRCT was more sensitive than chest radio-graphy. Conclusions The incidence of RA-ILD is associated with the activity and severity of RA. DLCO and HRCT are important for early detection of disease.