类风湿关节炎合并肺间质病变的临床相关因素分析
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摘要
目的分析类风湿关节炎(RA)合并肺间质病变(ILD)发生的临床相关因素。方法选取2016年6月-2017年6月于宁夏医科大学风湿科住院治疗的RA患者208例,根据胸部CT检查结果分为RA组和RA合并ILD组(RA-ILD组)。分析并比较两组患者的一般资料、实验室指标。结果两组患者性别、年龄、病程、吸烟比例差异均有统计学意义(P均<0.05);RA-ILD组患者CRP、抗-CCP抗体和RF水平及AKA阳性率均高于单纯RA组(P均<0.05)。两组间ESR、ANA、白细胞、中性粒细胞和血小板差异均无统计学意义(P均>0.05)。结论对于高龄、男性患者、吸烟史、病程长、AKA阳性、CRP阳性、高水平CCP抗体及高水平RF的RA患者应警惕ILD的发生,需早期行胸部CT检查,早期治疗,改善预后。
Objective To investigate the clinical correlation factor of rheumatoid arthritis(RA) with interstitial lung disease(ILD). Methods A total of 208 patients with RA treated in Department of Rheumatology of Ningxia Medical University from June 2016 to June 2017 were divided into RA group and RA combined with ILD group according to the results of chest CT examination. The general data and laboratory testing indicators were analyzed and compared between the two groups. Results There were significant differences in sex,age,course of disease and smoking rate between the two groups(P all <0.05).The CRP,anti-CCP antibody,RF level and positive rate of AKA in RA-ILD group were higher than those in the RA group(P all <0.05). There were no signifiant difference in ESR,ANA,white blood cell,neutrophil granulocyle and blood platelet between two groups. Conclusion For the older,male patients,smoking history,long course of disease,AKA positive,CRP positive,high titer CCP antibody and high RF levels RA patients should be alert to the development of ILD. Early chest CT examination and early treatment are needed to improve prognosis.
Objective To investigate the clinical correlation factor of rheumatoid arthritis(RA) with interstitial lung disease(ILD). Methods A total of 208 patients with RA treated in Department of Rheumatology of Ningxia Medical University from June 2016 to June 2017 were divided into RA group and RA combined with ILD group according to the results of chest CT examination. The general data and laboratory testing indicators were analyzed and compared between the two groups. Results There were significant differences in sex,age,course of disease and smoking rate between the two groups(P all <0.05).The CRP,anti-CCP antibody,RF level and positive rate of AKA in RA-ILD group were higher than those in the RA group(P all <0.05). There were no signifiant difference in ESR,ANA,white blood cell,neutrophil granulocyle and blood platelet between two groups. Conclusion For the older,male patients,smoking history,long course of disease,AKA positive,CRP positive,high titer CCP antibody and high RF levels RA patients should be alert to the development of ILD. Early chest CT examination and early treatment are needed to improve prognosis.
引文
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[2]张杨文.类风湿性关节炎血清RF与抗-CCP抗体浓度检测及其意义[J].实用医学杂志,2015,31(1):108-109.
[3]丁爽,段宏梅,方芳,等.类风湿性关节炎患者血清中结缔组织生长因子水平分析[J].细胞与分子免疫学杂志,2015,31(1):97-99.
[4]迟晶,彭科,杨小敏,等.类风湿性关节炎伴间质性肺病中肿瘤标志物对肺功能的影响分析[J].现代生物医学进展,2013,13(25):4885-4887.
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[11]孙文文,朱芸,李明,等.类风湿关节炎合并肺间质病变的发病相关因素[J].临床肺科杂志,2013,18(5):860-861.
[12] Mohd NN,Mohd Shahrir MS,Shahid MS,et al. Clinical and high resolution computed tomography characteristics of patients with rheumatoid arthritis lung disease[J]. International Journal of Rheumatic Diseases,2009,12(2):136-144.
[13] Zou YQ,Li YS,Ding XN,et al. The clinical significance of HRCT in evaluation of patients with rheumatoid arthritis-associated interstitial lung disease:a report from China[J]. Rheumatol Int,2012,32(3):669-673.
[14]张晓莉,刘志宇,王胜.类风湿关节炎伴随肺间质性病变的诊治进展[J].医药前沿,2013(34):26-28.
[15] Bongartz T,Nannini C,Medina-Velasquez YF,et al.Incidence and mortality of interstitial lung disease in rheumatoid arthritis:A population-based study[J].Arthritis&Rheumatism,2010,62(6):1583-1591.
[16] Shidara K,Hoshi D,Inoue E,et al. Incidence of and risk factors for interstitial pneumonia in patients with rheumatoid arthritis in a large Japanese observational cohort,IORRA[J]. Modern Rheumatology,2010,20(3):280-286.
[17] Habib HM,Eisa AA,Arafat WR,et al. Pulmonary in-volvement in early rheumatoid arthritis patients[J]. Clin Rheumatol,2011,30(2):217-221.
[18] Sebastiani M,Manfredi A,Cerri S,et al. Ferri C(2016)Radiologic classification of usual interstitial pneumonia in rheumatoid arthritis-related interstitial lung disease:correlations with clinical,serological and demographic features of disease[J]. Clin Exp Rheumatol,2016,34(3):564-565.
[19]宋良月,左大辰,张榕,等.类风湿关节炎合并肺间质疾病患者临床特点[J].中华临床免疫和变态反应杂志,2015(2):85-90.
[20]周浩彤,王友莲.类风湿关节炎合并肺间质病变的影响因素研究[J].中国全科医学,2017,20(10):1191-1195.
[21]陈超,徐升强,王银,等.抗环瓜氨酸肽抗体、抗核周因子在类风湿关节炎诊断中的意义[J].中国实验诊断学,2014(12):1981-1984.
[2]张杨文.类风湿性关节炎血清RF与抗-CCP抗体浓度检测及其意义[J].实用医学杂志,2015,31(1):108-109.
[3]丁爽,段宏梅,方芳,等.类风湿性关节炎患者血清中结缔组织生长因子水平分析[J].细胞与分子免疫学杂志,2015,31(1):97-99.
[4]迟晶,彭科,杨小敏,等.类风湿性关节炎伴间质性肺病中肿瘤标志物对肺功能的影响分析[J].现代生物医学进展,2013,13(25):4885-4887.
[5] Kim EJ,Elicker BM,Maldonado F,et al. Usual interstitial pneumonia in rheumatoid arthritis-associated interstitial lung disease[J]. European Respiratory Journal,2010,35(6):1322-1328.
[6] Ascherman DP. Interstitial lung disease in rheumatoid arthritis[J]. Current Rheumatology Reports,2010,12(5):363-369.
[7] Arnett FC,Edworthy SM,Bloch DA,et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis[J]. Arthritis&Rheumatism,1988,31(3):315-324.
[8] Neogi T,Aletaha D,Silman AJ,et al. The 2010American College of Rheumatology/European League Against Rheumatism classification criteria for rheumatoid arthritis:Phase 2 methodological report[J]. Arthritis&Rheumatism,2010,62(9):2582-2591.
[9] American Thoracic Society,European Respiratory Society. American Thoracic Society/European Respiratory Society international multidisciplinary consensus classification of the idiopathic interstitial pneumonias[J].Am J Respir Crit Care Med,2002,165(2):277-304.
[10]李松伟,李素云,郭洪涛,等.类风湿关节炎相关肺间质病变中医证候特征回顾性分析[J].中华中医药杂志,2013(4):1077-1080.
[11]孙文文,朱芸,李明,等.类风湿关节炎合并肺间质病变的发病相关因素[J].临床肺科杂志,2013,18(5):860-861.
[12] Mohd NN,Mohd Shahrir MS,Shahid MS,et al. Clinical and high resolution computed tomography characteristics of patients with rheumatoid arthritis lung disease[J]. International Journal of Rheumatic Diseases,2009,12(2):136-144.
[13] Zou YQ,Li YS,Ding XN,et al. The clinical significance of HRCT in evaluation of patients with rheumatoid arthritis-associated interstitial lung disease:a report from China[J]. Rheumatol Int,2012,32(3):669-673.
[14]张晓莉,刘志宇,王胜.类风湿关节炎伴随肺间质性病变的诊治进展[J].医药前沿,2013(34):26-28.
[15] Bongartz T,Nannini C,Medina-Velasquez YF,et al.Incidence and mortality of interstitial lung disease in rheumatoid arthritis:A population-based study[J].Arthritis&Rheumatism,2010,62(6):1583-1591.
[16] Shidara K,Hoshi D,Inoue E,et al. Incidence of and risk factors for interstitial pneumonia in patients with rheumatoid arthritis in a large Japanese observational cohort,IORRA[J]. Modern Rheumatology,2010,20(3):280-286.
[17] Habib HM,Eisa AA,Arafat WR,et al. Pulmonary in-volvement in early rheumatoid arthritis patients[J]. Clin Rheumatol,2011,30(2):217-221.
[18] Sebastiani M,Manfredi A,Cerri S,et al. Ferri C(2016)Radiologic classification of usual interstitial pneumonia in rheumatoid arthritis-related interstitial lung disease:correlations with clinical,serological and demographic features of disease[J]. Clin Exp Rheumatol,2016,34(3):564-565.
[19]宋良月,左大辰,张榕,等.类风湿关节炎合并肺间质疾病患者临床特点[J].中华临床免疫和变态反应杂志,2015(2):85-90.
[20]周浩彤,王友莲.类风湿关节炎合并肺间质病变的影响因素研究[J].中国全科医学,2017,20(10):1191-1195.
[21]陈超,徐升强,王银,等.抗环瓜氨酸肽抗体、抗核周因子在类风湿关节炎诊断中的意义[J].中国实验诊断学,2014(12):1981-1984.