尘肺病合并类风湿关节炎患者胸部CT影像学特点

A respective study on CT images of patients with both pneumoconiosis and rheumatoid arthritis

目的分析尘肺病合并类风湿关节炎（RA）患者临床表现及胸部CT特点，探讨尘肺病在RA发病中的重要作用。方法收集在四川大学第四附属医院住院的尘肺病患者中符合2009年ACR诊断分类标准的RA患者12例，研究受试者的尘肺病相关资料、RA表现及胸部CT影像学特点等指标。结果研究纳入RA合并尘肺病患者平均年龄（50．41±10．56）岁；工种主要为凿石或掘进，粉尘接触年限平均为7．36年；RA病程平均病程为（6．03±4．09）年，88．8％的患者类风湿因子水平升高。RA合并尘肺病患者的胸部CT表现以0．1～0．3cm小结节（100％）为主，还可出现肺大疱（16％）、空洞（25％）、胸膜增厚（33．3％）、肺气肿（41．6％）等改变。结论尘肺病与RA存在密切联系，应结合RA合并尘肺病患者血清学及胸部CT特点，重视该类患者的筛查和诊治。

Objective To analyze the clinical features and chest CT images of patients with both pneumoconiosis and rheumatoid arthritis, and study the important roles of pneumoconiosis in rheumatoid arthritis. Methods A retrospective study on inpatient of No. 4th affiliated hospital of Sichuan University from 2012 to 2016 was performed. Patients with pneumoconiosis met ACR classification criteria of rheumatic arthritis were enrolled. The features of pneumoconiosis and rheumatic arthritis as well as images of chest CT scan were analyzed. Results 12 patients with both pneumoconiosis and rheumatoid arthritis were recruited into the study. The average age of the subjects was 50.41± 10.56. The vocations of the subjects included mason and driving. The average duration of silica exposure was 6.03±4.09 years. 88.8 percents of the subjects showed positive rheumatoid factor. Chest CT scan of patients with both pneumoconiosis and rheumatoid arthritis mainly 3bowed nodules in lungs, 0. 1-0. 3cm in diameter, and other appearance include pneumatocele, cavity, pleural thickening, and emphysema. Conclusion There is a tight correlation between pneumoconiosis and rheumatoid arthritis. Accurate diagnoses of patients with both pneumoconiosis and rheumatoid arthritis should be made on the basis of serological and CT scan features.