类风湿关节炎合并肺间质病变的临床特点及相关因素

Clinical Features and Risk Factors in Patients with Rheumatoid Arthritis Combined with Interstitial Lung Disease

目的分析类风湿关节炎合并肺间质病变(RA-ILD)患者的临床特点及相关因素。方法回顾性分析2006年9月-2011年5月我院住院及门诊病人93例RA-ILD及93例未合并ILD的类风湿关节炎(RA)患者的一般情况、临床特点及类风湿因子(RF)、血沉(ESR)、C反应蛋白(CRP)、抗核抗体(ANA)及抗角蛋白抗体(AKA)、抗环瓜氨酸肽(CCP)抗体、抗SSA/SSB抗体、红细胞计数(RBC)、血红蛋白(HGB)、血小板计数(PLT)进行比较。结果 RA-ILD组患者呼吸系统症状多数以咳嗽为首发症状。RA-ILD组患者年龄、RF滴度、吸烟构成比均显著高于无ILD的RA组,有统计学意义(P均<0.05)。RA-ILD组病程、性别、ESR、CRP、ANA、抗SSA/SSB抗体,以及服用甲氨蝶呤与无ILD的RA组比较差异无统计学意义(P均>0.05)。经过后退法建立Logistic回归分析模型,多因素分析显示年龄(OR=1.093,95%CI 1.053～1.136,P<0.05),年龄每增大1岁,危险性增加0.093倍。结论年龄增大是RA发生ILD的相关因素,高龄的RA患者应警惕ILD的发生。

Objective To analyze the clinical features and risk factors of rheumatoid arthritis combined with interstitial lung disease(RA-ILD).Methods 93 cases with RA-ILDand 93 cases with RA without ILD from September,2006 to May,2011 were retrospectively analyzed.General,Clinical,rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),antinuclear antibody(ANA),anti-keratin antibody(AKA),anti-cyclic citrullinated peptide antibody(CCP),anti-SSA/anti-SSB,red blood cell(ESR),hemoglobin(HGB) and platelets(PLT) were compared between two groups.Results First symptoms of RA-ILD patients was cough.The age,RF level,prevalences of smoking in RA-ILD group were significantly higher than those in control group(P<0.05).The disease courses,sex,ESR,CRP,ANA,SSB,SSA and the therapeutic effect of methotrexate(MTX) had not significant difference between two groups(P>0.05).The Logistic regression model showed that onset age were significantly associated with pulmonary disease(OR=1.093,95%CI 1.053~1.136,P<0.05).With increasing age,the risk of disease increased.Conclusion The age of onset is the risk factors for ILD involvement in RA.