类风湿关节炎合并间质性肺疾病的临床特点  

The Association of Interstitial Lung Disease with Rheumatoid Arthritis

作　　者：李林蔚[1] 杜晶[1] 邓燕[1] 祖萍[1] 何太灵[1] 袁玉茹[1] 梁斌苗[1] 

机构地区：[1]四川大学华西医院呼吸与危重症医学科,四川成都610041

出　　处：《中国呼吸与危重监护杂志》2015年第2期165-167,共3页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：四川省科技厅支撑计划(编号:2014SZ0010)

摘　　要：目的分析类风湿关节炎(RA)合并间质性肺疾病(ILD)患者的相关临床特点,探讨RA发生ILD的危险因素。方法收集四川大学华西医院风湿免疫科住院的RA患者,记录其临床资料、实验室数据及肺功能结果,并根据高分辨CT(HRCT)结果将其分为RA-ILD组与RA无ILD组,对组间资料进行比较,并对RA是否合并ILD的危险因素进行Logistic回归分析。结果共计59例RA患者被纳入研究,ILD的发生率为42.3%。在RA-ILD患者组中,类风湿因子(RF)、糖蛋白抗原15-3(CA15-3)与糖蛋白抗原12-5(CA125)明显增高,而深吸气量(IC)和肺一氧化碳弥散量(DLCO)明显低于RA无ILD患者组。Logistic回归分析显示,增高的CA15-3和降低的DLCO与RA-ILD的发生相关。结论 RA-ILD发生率高,CA15-3和DLCO是RA发生ILD的危险因素。Objective To evaluate the prevalence of interstitial lung disease( ILD) in patients with rheumatoid arthritis( RA),and explore the association of ILD with RA. Methods Patients who were diagnosed as RA were recruited in the study,and were categorized into a RA-ILD group and a non-ILD group according to high-resolution computed tomography( HRCT). The data of clinical characteristics,serum biomarkers measurement,and pulmonary function test were collected. Logistic regression analysis was performed to evaluate the factors associated with the incidence of ILD in RA. Results A total of 59 patients with RA were enrolled. The incidence of ILD in RA was 42. 3%. The rheumatoid factor( RF),carbohydrate antigen 15-3( CA15-3),carbohydrate antigen12-5( CA125),inspiratory capacity( IC) and diffusion capacity for carbon monoxide of the lung( DLCO) were significantly different between two groups( all P <0. 05). Multivariate logistic regression analysis revealed that the increased CA15-3 and decreased DLCO were independent risk factors for ILD in the patients with RA. Conclusions The occurrence of ILD with RA seems very high. CA15-3 and DLCO may be important risk factors for the incidence of ILD in patients with RA.

关 键 词：类风湿关节炎 间质性肺疾病 危险因素 

分 类 号：R593.22[医药卫生—内科学] R563[医药卫生—临床医学]