类风湿性关节炎相关性间质性肺疾病101例临床分析

Clinical analysis of 101 cases with rheumatoid arthritis associated interstitial lung disease.

目的探讨类风湿性关节炎相关性间质性肺疾病(RA-ILD)的临床特点,以提高对该病的认识水平。方法回顾性分析类风湿性关节炎(RA)患者582例,并将其分为单纯RA组和RA-ILD组,对2组患者的临床资料进行分析。结果在582例RA患者中,合并肺间质病变患者101例,占17.35%,与单纯RA患者相比,RA-ILD多见于病程长、病情重的患者。在101例RA-ILD患者中,男性46例,女性55例,2组患者男女性别比例差异无统计学意义。RA-ILD患者85例存在不同程度咳嗽(主要为干咳)、呼吸困难等,16例无明显呼吸系统症状,影像学检查均有不同程度的双肺弥漫性病变,表现为网格样、小结节样、磨砂玻璃样或蜂窝样改变等。与单纯RA组患者相比,RA-ILD患者血清类风湿因子(RF)及抗环瓜氨酸肽抗体(CCP)水平无明显差异,雷诺现象明显多于单纯RA组患者。结论对病情重、病程长或存在雷诺现象的RA患者,如出现咳嗽、气短等症状应高度重视有无合并肺间质改变并早期干预。

Objective To investigate the clinical features of rheumatoid arthritis associated interstitial lung disease（ RA-ILD）. Methods The clinical data of 582 cases with rheumatoid arthritis（ RA） were analyzed retrospectively,and divided into the simple RA group and the RA-ILD group. The clinical features of the two groups patients with review of literature were investigated.Result There were 101 cases with RA-ILD（ 17. 35%） in the total of 582 patients. Compared with RA patients,older age,longer history andsevere illness status are the common risk factors of RA-ILD. There were 46 males and 55 females among the 101 patients with RA-ILD. There were no significant difference in sex ratio between the simple RA and the RA-ILD groups. 85 patients had cough and shortness of breath,16 cases had no significant respiratory syndromes among the RA-ILD patients. All the RA-ILD patients had imaging manifestations,such as diffuse changes,ground-glass changes,reticular changes. Comparing with the simple RA patients,there were no significant differences in serum RF and CCP level respectively,and Raynaud＇s phenomenon were more commonly in RA-ILD patients. Conclusion For the long history and severe illness RA patients,it should pay more attention to interstitial lung disease.