类风湿关节炎合并肺间质纤维化31例临床观察

Interstitial pulmonary fibrosis in rheumatoid arthritis(report of 31 cases)

目的:总结类风湿关节炎(RA)合并肺间质纤维化的临床特点、肺功能、影像学检查,加深对(RA)肺间质病变的认识。方法:回顾性分析郑州大学第一附属医院呼吸内科2009年10月至2010年10月期间31例RA并发肺间质纤维化住院患者的临床资料,包括类风湿因子(RF)、血气分析、胸部X线、肺高分辨CT(HRCT)、肺功能检查、血常规等。结果:所有患者中RF强阳性23例,血沉(ESR)增高28例,C反应蛋白(CRP)升高25例,血小板增高17例,低氧血症22例3,例死亡,死亡原因为I型呼吸衰竭。结论:肺间质纤维化的发生与重症类风湿关节炎有关联,RA患者应尽早做肺高分辨CT、肺功能检查,达到肺部病变的早期诊断和治疗,尤其是RF强阳性的RA患者。

Objective：To explore the clinical characteristics,pulmonary function and radiographic findings of pulmonary interstitial fibrosis in rheumatoid arthritis（RA）to build up knowledge for early diagnosis. Methods：The clinical dates of 31 admitted RA patients from october 2009 to october 2010 were analyzed retrospectively including rheumatoid factor（RF）,blood-gas analysis,chest X-ray,chest HRCT,pulmonary function tests,routine blood and so on. Results：Among the 31 RA patients with IPF,23 cases were with strongly positive RF,28 cases with elevated ESR,25 cases with elevated CRP,17 cases with elevated platelets account and 22 cases with hypoxemia.3 patients died from type Ⅰ respiratory failure. Conclusion：HRCT and pulmonary function test should be taken early in order to get early diagnosis and treatment,especially in those with strongly positive RF.