中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2015年
4期
233-237
,共5页
关节炎,类风湿%肺疾病,间质性%疾病特征
關節炎,類風濕%肺疾病,間質性%疾病特徵
관절염,류풍습%폐질병,간질성%질병특정
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目的 探讨RA相关性间质性肺疾病(ILD)的临床特点和危险因素.方法 回顾性分析595例RA患者病历资料,其中550例患者行肺高分辨CT检查.危险因素分析采用Logistic回归分析.结果 ①595例RA患者中发生ILD者237例(39.8％),RA-ILD患者中13.5％ILD发生于RA诊断前,69.7％ILD发生于RA诊断10年内,16.8％发生于RA诊断10年以上.②RA-ILD常见的胸部CT表现有网格影(57.8％)、胸膜肥厚(57.0％)、磨玻璃影(53.2％),其次为小叶间隔增厚、结节影、肺大泡、蜂窝样改变和支气管扩张.③RA-ILD常与胸膜病变、支气管扩张、肺动脉高压等同时存在.④与RA无ILD(RA-N-ILD)患者比较,RA-ILD患者男性比率高、吸烟比率高、发病年龄大、病程短、关节肿胀数多,LDH、球蛋白水平、ESR、CRP、RF水平升高,差异具有统计学意义(P＜0.05).同时,肺功能的用力肺活量、1 s用力呼气容积、一氧化碳弥散率等较RA-N-ILD患者减低,差异具有统计学意义(P＜0.05).Logistic回归分析提示高龄、吸烟、乳酸脱氢酶升高、RF阳性与RA-ILD密切相关.结论 RA患者常发生ILD,RA-ILD多发生在RA发病后的10年内,可与其他肺部损害并存,高龄、吸烟、乳酸脱氢酶升高、RF阳性与RA-ILD密切相关.
目的 探討RA相關性間質性肺疾病(ILD)的臨床特點和危險因素.方法 迴顧性分析595例RA患者病歷資料,其中550例患者行肺高分辨CT檢查.危險因素分析採用Logistic迴歸分析.結果 ①595例RA患者中髮生ILD者237例(39.8％),RA-ILD患者中13.5％ILD髮生于RA診斷前,69.7％ILD髮生于RA診斷10年內,16.8％髮生于RA診斷10年以上.②RA-ILD常見的胸部CT錶現有網格影(57.8％)、胸膜肥厚(57.0％)、磨玻璃影(53.2％),其次為小葉間隔增厚、結節影、肺大泡、蜂窩樣改變和支氣管擴張.③RA-ILD常與胸膜病變、支氣管擴張、肺動脈高壓等同時存在.④與RA無ILD(RA-N-ILD)患者比較,RA-ILD患者男性比率高、吸煙比率高、髮病年齡大、病程短、關節腫脹數多,LDH、毬蛋白水平、ESR、CRP、RF水平升高,差異具有統計學意義(P＜0.05).同時,肺功能的用力肺活量、1 s用力呼氣容積、一氧化碳瀰散率等較RA-N-ILD患者減低,差異具有統計學意義(P＜0.05).Logistic迴歸分析提示高齡、吸煙、乳痠脫氫酶升高、RF暘性與RA-ILD密切相關.結論 RA患者常髮生ILD,RA-ILD多髮生在RA髮病後的10年內,可與其他肺部損害併存,高齡、吸煙、乳痠脫氫酶升高、RF暘性與RA-ILD密切相關.
목적 탐토RA상관성간질성폐질병(ILD)적림상특점화위험인소.방법 회고성분석595례RA환자병력자료,기중550례환자행폐고분변CT검사.위험인소분석채용Logistic회귀분석.결과 ①595례RA환자중발생ILD자237례(39.8％),RA-ILD환자중13.5％ILD발생우RA진단전,69.7％ILD발생우RA진단10년내,16.8％발생우RA진단10년이상.②RA-ILD상견적흉부CT표현유망격영(57.8％)、흉막비후(57.0％)、마파리영(53.2％),기차위소협간격증후、결절영、폐대포、봉와양개변화지기관확장.③RA-ILD상여흉막병변、지기관확장、폐동맥고압등동시존재.④여RA무ILD(RA-N-ILD)환자비교,RA-ILD환자남성비솔고、흡연비솔고、발병년령대、병정단、관절종창수다,LDH、구단백수평、ESR、CRP、RF수평승고,차이구유통계학의의(P＜0.05).동시,폐공능적용력폐활량、1 s용력호기용적、일양화탄미산솔등교RA-N-ILD환자감저,차이구유통계학의의(P＜0.05).Logistic회귀분석제시고령、흡연、유산탈경매승고、RF양성여RA-ILD밀절상관.결론 RA환자상발생ILD,RA-ILD다발생재RA발병후적10년내,가여기타폐부손해병존,고령、흡연、유산탈경매승고、RF양성여RA-ILD밀절상관.
Objective To identify the clinical features and risk factors of rheumatoid arthritis-associated interstitial lung disease (RA-ILD).Methods The clinical and laboratory data of 595 patients with RA hospitalized in Chaoyang Hospital.550 cases of patients were performed pulmonary high-resolution CT examination.Risk factors were analyzed with logystic regression analysis.Results ① There were 237 (39.8％)patients with RA-ILD.13.5％ of RA-ILD occurred before the dia-gnosis of RA,69.7％ of RA-ILD occurred within ten years after the diagnosis of RA,16.8％ of RA-ILD occurred more than ten years after the diagnosis of RA.② The most common manifestations of HRCT were reticular opacity (57.8％),pleural thickening (57％),ground-glass opacity (53.2％),followed by septal thicke-ning,nodules,bullae,cellular-like changes and bronchiectasis.③ Pleural disease,bronchiectasis,pulmonary hypertension in RA patients were associated with RA-ILD.④ Compared with the RA-N-ILD patients,RA-ILD patients had a higher proportion of male patients,higher rate of smoking,older mean age at onset,shorter duration,more swollen joints higher levels of lactate dehydrogenase,globulin,erythrocyte sedimentation,C-reactive protein and rheumatoid factor,the difference was statistically significant (P＜0.05).The forced vital capacity,forced expiratory volume in one second,carbon monoxide diffusion rate was lower,the difference was statistically significant (P＜0.05).Logistic regression analysis showed that age,smoking,elevated lactate dehydrogenase,RF-positive rate were relevant factors of RA-ILD.Conclusion ILD is common in RA,and most of it occurrs within ten years after the diagnosis of RA,and often coexists with other lung disease.Age,smoking,elevated lactate dehydrogenase,RF-positive rate
