类风湿关节炎相关肺间质病变患者临床特征及危险因素分析

doi:10.3969/j.issn.1004-583X.2019.12.005

临床荟萃

类风湿关节炎相关肺间质病变患者临床特征及危险因素分析

1.川北医学院，四川南充 637000；2.川北医学院第二附属医院，四川南充 637000；
3.川北医学院附属医院 a.风湿免疫科；b.老年科, 四川南充 637000

出版日期:2019-12-20 发布日期:2020-01-19
通讯作者: 青玉凤， Email：qingyufengqq@163.com
基金资助:
四川大学华西医院专职博士后研发基金资助----MicroRNA-146参与结缔组织疾病相关肺间质疾病发病的分子机制研究（2018HXBH017）

Analysis of clinical features and risk factors in rheumatoid arthritisrelated interstitial lung disease

1. North Sichuan Medical College, Nanchong 637000, China; 2. The Second Affiliated Hospital of
North Sichuan Medical College, Nanchong 637000, China; 3a.Department of Rheumatology
and Immunology; b.Department of Geriatrics, Affiliated Hospital of North Sichuan
Medical College, Nanchong 637000, China

Online:2019-12-20 Published:2020-01-19
Contact: Corresponding author：Qing Yufeng, Email：qingyufengqq@163.com

摘要/Abstract

摘要： 目的分析类风湿关节炎（RA）相关肺间质病变（ILD）的临床特征及危险因素。方法 2017年1月1日至2018年6月30日诊治的RA患者373例，根据临床表现及肺部高分辨率CT（HRCT）分为RA合并ILD组与RA未合并肺间质病变(NILD)组，分析两组患者临床特征。结果 ①373例RA患者中229例发生ILD，其中76例出现呼吸系统症状；② ILD组年龄、发病年龄、男/女均高于NILD组；③ ILD组患者关节肿胀数、压痛数大于NILD组；晨僵、咳嗽、咳痰与活动后气促的发生率高于NILD组；④ ILD组红细胞沉降率、白细胞计数、中性粒细胞计数、极低密度脂蛋白、超敏C反应蛋白、尿素、肌酐、尿酸、胱抑素C、类风湿因子、抗环瓜氨酸肽抗体水平均高于NILD组；白蛋白、载脂蛋白A1水平均低于NILD组；⑤ 年龄、关节受累数、抗CCP抗体是RA合并ILD的独立危险因素，白蛋白是其保护因素。结论 RA容易合并ILD，但发生隐匿；高龄、关节受累重、高滴度抗CCP抗体是其危险因素。

关键词: 关节炎, , 类风湿, 肺疾病, , 间质性, 临床特征, 危险因素

Abstract: Objective To investigate the clinical features and risk factors of rheumatoid arthritis（RA）related interstitial lung disease(ILD) . Methods A total of 373 RA patients treated from January 1st 2017 to June 30th 2018 were collected. According to the clinical manifestations and highresolution CT (HRCT) of the lungs, the patients were divided into RA with ILD group and RA with non ILD(NILD) group. Then the clinical features of these two groups were analyzed.Results ①Of 373 RA patients, 229 cases had ILD and 76 cases had respiratory symptoms. ② The age, age of onset and the ratio of male and female were higher in ILD group than those in NILD group; ③The number of swollen joints, tenderness joints, and incident of morning stiffness, cough and postexercise shortness in ILD group were higher than those of NILD group; ④The levels of erythrocyte sedimentation rate, white blood cell count, neutrophil count, low density lipoprotein, hypersensitive Creactive protein, urea, creatinine, uric acid, cystatin C, rheumatoid factor, anticyclic citrullinated peptide antibody in ILD were higher than those of NILD group. The levels of albumin and apolipoprotein A1 were lower than those of NILD group; ⑤ Age, number of joint involvement and antiCCP antibody were independent risk factors for RArelated ILD, and albumin was the protective factor. Conclusion RA is easy to combine with ILD, but it is concealed. The risk factors are advanced age, heavy joint involvement and high titer antiCCP antibody.

Key words: arthritis, , rheumatoid； lung , diseases, , interstitial; , clinical characteristics, risk factors

秦倩1, 2，杨小红1, 2，周闻君3a，熊琴3b，郑建雄3a，张全波3b，青玉凤3a. 类风湿关节炎相关肺间质病变患者临床特征及危险因素分析[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2019.12.005.

Qin Qian1, 2, Yang Xiaohong1, 2, Zhou Wenjun3a, Zheng Jianxiong3a, Xiong Qin3b, Zhang Quanbo3b, Qing Yufeng3a. Analysis of clinical features and risk factors in rheumatoid arthritisrelated interstitial lung disease[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2019.12.005.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2019.12.005

https://huicui.hebmu.edu.cn/CN/Y2019/V34/I12/1081

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类风湿关节炎相关肺间质病变患者临床特征及危险因素分析

Analysis of clinical features and risk factors in rheumatoid arthritisrelated interstitial lung disease

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