类风湿关节炎并间质性肺炎16例临床分析

Rheumatoid arthritis and interstitial lung disease 16 cases of clinical analysis

目的:探讨类风湿关节炎合并间质性肺炎的临床特点,提高此疾病的认识水平。方法:对16例类风湿关节炎合并间质性肺炎患者的临床资料进行回顾性分析。结果:类风湿关节炎的活动度与肺间质病变发病率呈正相关性。16例类风湿关节炎合并间质性肺炎患者中,其中6例呼吸系统尚无明显症状,其余在不同程度上表现为干咳、呼吸困难等,影像学检查均有不同程度双肺弥漫性病变,表现为网格样、小结节样、磨砂玻璃样或蜂窝样改变等。16例患者均接受糖皮质激素和(或)免疫抑制剂治疗,14例病情好转,1例死亡,1例因合并真菌感染而终止肺间质治疗。结论:①在应用糖皮质激素基础上早期联用免疫抑制剂可改善患者的预后,但也增加感染的风险。②对RA患者应常规行肺部CT检查,尽早发现肺间质病变。

Objective：To discover the clinical characteristics of rheumatoid arthritis merger interstitial lung disease,to improve the level of understanding of the disease. Methods： Sixteen cases of rheumatoid arthritis with interstitial lung disease patients clinical data were retrospectively analyzed. Results： Rheumatoid arthritis of the activity was positively correlation with pulmonary interstitial disease incidence. During 16 cases of rheumatoid arthritis merger interstitial lung disease patients, 6 cases of the respiratory system was no obvious symptoms, in part, for the performance of the dry cough, difficulty breathing. The imaging examination all had different rate double pulmonary diffuse disease, for the performance of the grid sample, small nodules sample, ground glass sample or honeycomb- like change, etc. All patients were accepted glucocorticoid and （or） immunosuppressant therapy, and 14 cases were improved, 1 case death, 1 case merger fungal infection and termination of pulmonary interstitial therapy. Conclusion： ①The application of glucocorticoid combined immune inhibitor with early can improve the prognosis of patients, but also increase the risk of infection. ②Patients with RA should be normal lung CT examination,in order to early detection of lung interstitial lesions.